title: Comparison of electromyography and kinemyography during recovery from non-depolarising neuromuscular blockade.
abstract: In this study, two commercially available quantitative neuromuscular function monitoring techniques, electromyography (EMG) and kinemyography (KMG), were compared with respect to repeatability and accuracy during late recovery from neuromuscular blockade. Train-of-four (TOF) ratios were recorded in 30 patients using KMG and EMG at the adductor pollicis muscle. Measurements were taken on the same hand using the Datex-Ohmeda NeuroMuscular Transmission monitor (GE Healthcare, Helsinki, Finland). Instrumental precision was evaluated using the coefficient of repeatability, while accuracy was assessed using the bias and limits of agreement. The coefficients of repeatability were similar for both techniques (0.035 for KMG and 0.043 for EMG), indicating a similar level of precision. KMG overestimated the TOF ratios measured with EMG with a bias of 0.11 (95% limits of agreement: -0.13 to 0.35). At a TOF ratio of 0.90 the bias was 0.08 (95% limits of agreement: -0.08 to 0.25). This means that at a TOF ratio of 0.90 measured with KMG will be approximately equivalent to a TOF ratio of 0.80 measured with EMG at the adductor pollicis muscle, but it may indeed be as low as 0.65 or as high as 1.00. Therefore, TOF ratios measured by KMG and EMG cannot be used interchangeably.
authors.affiliation: Department of Anaesthesia, Sydney Adventist Hospital, Wahroonga, New South Wales, Australia, and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: P A
authors.initials: PA
authors.lastname: Stewart
authors.forename: N
authors.initials: N
authors.lastname: Freelander
authors.forename: S
authors.initials: S
authors.lastname: Liang
authors.forename: G
authors.initials: G
authors.lastname: Heller
authors.forename: S
authors.initials: S
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D061886:Neuromuscular Monitoring; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*
chemical_list: D003473:Neuromuscular Nondepolarizing Agents
keywords: ElectroSensor; MechanoSensor; electromyography; kinemyography; quantitative neuromuscular function monitoring