title: Comparison of mechanomyography and acceleromyography for the assessment of rocuronium induced neuromuscular block in myotonic dystrophy type 1.
abstract: We measured acceleromyography and mechanomyography simultaneously with monitoring of rocuronium-induced neuromuscular block in four patients with myotonic dystrophy type 1. Furthermore, we compared neuromuscular block measures from these patients with those from normal controls from previous studies. In myotonic dystrophy type 1 patients, the dose-response curve obtained with acceleromyography was steeper and right-shifted compared with that obtained using mechanomyography. However, the effective doses to produce 95% neuromuscular block determined with both acceleromyography and mechanomyography were similar to each other and to values found in normal patients. In the three myotonic dystrophy type 1 patients with mild to moderate disease, times to recovery from block were similar to those observed in normal controls. In both patients and normal controls, neuromuscular block recovered faster with acceleromyography. However, in one patient with severe muscle wasting, recovery of neuromuscular block was prolonged. We conclude that mechanomyography and acceleromyography cannot be used interchangeably to monitor neuromuscular block in myotonic dystrophy type 1 patients.
authors.affiliation:  Staff Anaesthesiologist, Department of Anaesthesiology, Sint-Vincentius Hospital, Affiliated to the University of Antwerp, Belgium.
authors.forename: L E H
authors.initials: LEH
authors.lastname: Vanlinthout
authors.affiliation:  Professor of Anaesthesiology.
authors.forename: L H D J
authors.initials: LHDJ
authors.lastname: Booij
authors.affiliation:  Staff Physicist.
authors.forename: J
authors.initials: J
authors.lastname: Van Egmond
authors.affiliation:  Staff Anaesthesiologist, Department of Anaesthesiology, Radboud University, Medical Centre Nijmegen, The Netherlands.
authors.forename: E N
authors.initials: EN
authors.lastname: Robertson
mesh_terms: D000328:Adult; D000732:Androstanols / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009213:Myography / Q000379:methods*; D009223:Myotonic Dystrophy / Q000503:physiopathology*; D019148:Neuromuscular Blockade / Q000379:methods*; D009469:Neuromuscular Junction / Q000187:drug effects* / Q000503:physiopathology; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000494:pharmacology*; D000077123:Rocuronium
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium