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British Journal of Anaesthesia, Vol 80, Issue 3 384-385, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATION

Neuromuscular monitoring by intensive care nurses: comparison of acceleromyography and tactile assessment

R. Greer, NJN. Harper and A. J. Pearson
Intensive Care Unit, Manchester Royal Infirmary, Manchester M13 9WL

We have compared tactile assessment of the train-of-four (TOF) count and TOF ratio by nursing staff, with measurements made by a new acceleromyographic monitor, the TOF-Watch. We assessed neuromuscular block in 30 sedated intensive care patients receiving a continuous infusion of atracurium. Five nurses made a tactile assessment of neuromuscular block in each patient within a 5-min period. Each assessment was paired with a blinded TOF-Watch measurement. The nurses were accurate in assessing twitch count in 55% of measurements and they tended to overestimate the degree of block using tactile assessment of TOF ratio.
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