Dan Med Bull
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Review Comparative Study
Monitoring of neuromuscular transmission by electromyography during anaesthesia. A comparison with mechanomyography in cat and man.
In this study the applicability of the electromyographical method for monitoring neuromuscular transmission during anaesthesia has been investigated. The purpose was to determine the stability and temperature dependence of the EMG and to evaluate and compare EMG area, amplitude and duration during a non-depolarizing neuromuscular block in the tibialis anterior muscle preparation of the cat. Further, in clinical studies the purpose was to investigate differential hand muscle sensitivity to non-depolarizing neuromuscular blocking agents based on the EMG and the standard adductor pollicis mechanomyogram, and to establish the agreement between the electromyographical and the mechanomyographical methods and their relationship to clinical parameters of residual neuromuscular block. ⋯ However, due to the range of deviations between the EMG and the mechanomyogram, EMG TOF ratios down to 0.55 or up to 0.90 in some patients were found to be compatible with adequate recovery of a mechanomyographical TOF ratio of 0.75. Differences between electromyographical and mechanomyographical TOF ratios in their relation to 5 s sustained headlift were only revealed when the TOF ratio was below 0.50-0.60. More patients were then able to perform the test if the TOF ratio was measured from the EMG.(ABSTRACT T