Clinical validation of electromyography and acceleromyography as sensors for muscle relaxation.
OBJECTIVE
The aim of this study was to determine which of two clinically applied methods, electromyography or acceleromyography, was less affected by external disturbances, had a higher sensitivity and which would provide the better input signal for closed loop control of muscle relaxation.


METHODS
In 14 adult patients, anaesthesia was induced with intravenous opioids and propofol. The response of the thumb to ulnar nerve stimulation was recorded on the same arm. Mivacurium was used for neuromuscular blockade. Under stable conditions of relaxation, the infusion-rate was decreased and the effects of turning the hand were investigated.


RESULTS
Electromyography and acceleromyography both reflected the change of the infusion rate (P = 0.015 and P < 0.001, respectively). Electromyography was significantly less affected by the hand-turn (P = 0.008) than acceleromyography. While zero counts were detected with acceleromyography, electromyography could still detect at least one count in 51.1%.


CONCLUSIONS
Electromyography is more reliable for use in daily practice as it is less influenced by external disturbances than acceleromyography.
Hänzi
P
P
University Hospital of Bern, Department of Anaesthesiology, Murtenstrasse, Bern, Switzerland.
Leibundgut
D
D
Wessendorf
R
R
Lauber
R
R
Zbinden
A M
AM
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004558:Electric Stimulation / Q000379:methods; D004576:Electromyography / Q000379:methods*; D005260:Female; D006225:Hand / Q000502:physiology; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077590:Mivacurium; D009126:Muscle Relaxation; D009213:Myography / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015742:Propofol / Q000627:therapeutic use; D013933:Thumb / Q000294:innervation; D014459:Ulnar Nerve / Q000378:metabolism
D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D015742:Propofol