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BJA Advance Access originally published online on January 31, 2008
British Journal of Anaesthesia 2008 100(3):344-350; doi:10.1093/bja/aem379
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Comparison of a new neuromuscular transmission monitor compressomyograph with mechanomyograph

A. A. Dahaba1,*, H. Bornemann1, B. Holst2,3, G. Wilfinger1 and H. Metzler1

1 Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria
2 Institute of Experimental Physics, Graz University of Technology, Graz, Austria
3 Department of Physics and Technology, University of Bergen, Norway

* Corresponding author. E-mail: ashraf.dahaba{at}meduni-graz.at

Background: We developed a new neuromuscular transmission monitor, the compressomyograph (CMG, European patent number: EP 06018557.6, US patent number: US 60/824.541). This is the first preliminary report comparing neuromuscular block monitored by CMG and the Relaxometer® mechanomyograph (MMG).

Methods: The two monitors were randomly allocated to the left or right hands of 16 patients. T1, first twitch of the train-of-four (TOF) expressed as percentage of control response, and the TOF ratio (T4:t1) were used to evaluate the neuromuscular block produced by rocuronium 0.6 mg kg–1.

Results: The CMG monitor exhibited no pre-relaxation reverse fade (T4>T1) or T1 exceeding 100%. There was no significant difference in mean (SD) onset time, Dur25 (time to T1 25% recovery), or Dur0.9 (time to 0.9 TOF ratio recovery) measured by the CMG [2.4 (0.9), 22.6 (4.1), 43.1 (10.3) min, respectively] compared with MMG [2.1 (0.9), 22.9 (3.3), 43.3 (10.0) min, respectively]. According to Bland and Altman analysis, the bias (upper and lower limits of agreement) for T1% was –0.3% (+13.4% and –13.8%) and for TOF ratio was –0.009 (+0.068 and –0.085). CMG showed 100% sensitivity and 75% specificity in indicating full relaxation for tracheal intubation, and 80% sensitivity with 86% specificity in predicting MMG 0.9 TOF ratio.

Conclusions: The CMG could be a reliable clinical monitor in the daily anaesthesia practice that does not require time to set up or rigid support of the arm.

Keywords: measurement techniques, neuromuscular block, mechanomyograph; monitoring; neuromuscular block, rocuronium


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