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TECHNOLOGY, COMPUTING, AND SIMULATION

The Neuromuscular Transmission Module Versus the Relaxometer Mechanomyograph for Neuromuscular Block Monitoring

Ashraf A. Dahaba, MD MSc^*, Fedor von Klobucar, MD^*, Peter H. Rehak, PhD, and Werner F. List, MD^*

*Department of Anaesthesiology and Intensive Care Medicine and Department of Surgery, Biomedical Engineering and Computing Unit, Karl Franzens University, Graz, Austria

Address correspondence and reprints to Ashraf Dahaba, MD, Department of Anaesthesiology and Intensive Care Medicine, Karl Franzens University, Auenbruggerplatz 29, A-8036, Graz, Austria. Address e-mail to Ashraf.Dahaba{at}kfunigraz.ac.at

The neuromuscular transmission module (M-NMT) is an integrated piezoelectric motion sensor module incorporated in the AS/3^TM anesthesia monitor. We compared the neuromuscular block of 0.6 mg/kg rocuronium (twice the 95% effective dose) monitored by the M-NMT with that monitored by the Relaxometer^® mechanomyograph (MMG). The two monitors were alternately allocated to the left or right hands of 20 patients. T₁%, the first twitch of the train-of-four (TOF), and the TOF ratio (T₄/T₁) were used for evaluating the neuromuscular block. There was no significant difference in the mean (min) ± SD onset time or time to 0.8 TOF ratio recovery measured by the M-NMT (1.5 ± 0.3, 49.4 ± 8.1) compared with MMG (1.8 ± 0.6, 50.9 ± 9.9), respectively. However, the time (min) to 25% T₁ recovery was significantly longer when monitored by the M-NMT (25.6 ± 8) than by the MMG (20.2 ± 6.3). During recovery from neuromuscular block, the difference between the TOF ratios measured by the two monitors showed a bias of -0.031, and the limits of agreement (bias ±1.96 SD) were -0.281 and +0.22. The M-NMT monitor could determine the time to tracheal intubation as well as full recovery from neuromuscular block, but it lagged behind the MMG in determining the time to rocuronium repeat dose administration.

IMPLICATIONS:Compared with the Relaxometer mechanomyograph, the neuromuscular transmission module could equally indicate time to tracheal intubation and full recovery from 0.6 mg/kg rocuronium neuromuscular block. Its small quick-fit sensor has the advantage, in an often crowded and busy operating room, of being incorporated in the AS/3^TM anesthesia workstation.

This article has been cited by other articles:

				A. A. Dahaba, H. Bornemann, B. Holst, G. Wilfinger, and H. Metzler Comparison of a new neuromuscular transmission monitor compressomyograph with mechanomyograph Br. J. Anaesth., March 1, 2008; 100(3): 344 - 350. [Abstract] [Full Text] [PDF]

				G. Trager, G. Michaud, S. Deschamps, and T. M. Hemmerling Comparison of phonomyography, kinemyography and mechanomyography for neuromuscular monitoring: [Comparaison de la phonomyographie, la cinemyographie et la mecanomyographie pour le monitorage neuromusculaire] Can J Anesth, February 1, 2006; 53(2): 130 - 135. [Abstract] [Full Text] [PDF]

				T. M. Hemmerling and F. Donati Neuromuscular blockade at the larynx, the diaphragm and the corrugator supercilii muscle: a review: [Blocage neuromusculaire du larynx, du diaphragme et du muscle sourcilier : une revue] Can J Anesth, October 1, 2003; 50(8): 779 - 794. [Abstract] [Full Text] [PDF]

				T. M. Hemmerling, F. Donati, and A. A. Dahaba The M-NMT Mechanosensor Cannot be Considered as a Reliable Clinical Neuromuscular Monitor in Daily Anesthesia Practice * Response Anesth. Analg., December 1, 2002; 95(6): 1826 - 1827. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999