Document Detail

Duration of control stimulation does not affect onset and offset of neuromuscular blockade at the corrugator supercilii muscle measured with phonomyography or acceleromyography.
MedLine Citation:
PMID:  12419715     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Phonomyography (PMG) is a novel technique for measuring neuromuscular blockade (NMB). The effect of the duration of control stimulation on the onset and duration of blockade was investigated using PMG and acceleromyography (AMG). METHODS: After induction of anesthesia, a microphone was placed above the middle portion of the left eyebrow, and an acceleromyographic probe was placed above the middle portion of the right eyebrow. Twenty patients were randomized to receive bilateral, single-twitch, facial nerve stimulation (0.1 Hz, 20 mA) with three minutes (n = 10) or ten minutes (n = 10) of supramaximal stimulation before mivacurium 0.2 was administered. Onset, maximum effect, and offset of NMB were measured. RESULTS: Using PMG, lag time, onset time, maximum effect, and time to reach 75% of control twitch height (mean +/- SD) were 36 +/- 27 sec, 136 +/- 35 sec, 89 +/- 10%, and 12.1 +/- 4.5 min, respectively, after three minutes of control stimulation and were 40 +/- 22 sec, 122 +/- 40 sec, 93 +/- 3%, and 12.4 +/- 4.9 min, after ten minutes. Using AMG, the values were 38 +/- 23 sec, 106 +/- 28 sec, 79 +/- 6%, and 14.3 +/- 5.9 min, respectively, after three minutes and were 34 +/- 22 sec, 106 +/- 28 sec, 76 +/- 10%, and 14.9 +/- 3.7 min, after ten minutes. Compared to PMG, AMG revealed significant bias for onset time (-30 sec), maximum effect (-16%) and time to reach 75% of control twitch height (1.5 min), with wide limits of agreement of 66 sec, 22%, and 5.6 min, respectively. CONCLUSION: The duration of control stimulation did not influence the time course of blockade measured by either method. Three minutes of supramaximal stimulation is sufficient to measure pharmacodynamic parameters. AMG measures a shorter onset and longer recovery time and reduced anesthesiology the maximum effect compared to PMG.
Thomas M Hemmerling; François Donati; Denis Babin; Pierre Beaulieu
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Evaluation Studies; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  49     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-06     Completed Date:  2003-01-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  913-7     Citation Subset:  IM    
Department of Anesthesia, Neuromuscular Research Group, Centre Hospitalier de l'Université de Montréal (CHUM) and the Department of Anesthesiology, Université de Montréal, Montréal, Québec, Canada.
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MeSH Terms
Anesthesia, General*
Data Interpretation, Statistical
Electric Stimulation
Facial Nerve / physiology
Middle Aged
Muscle Contraction / drug effects
Muscle, Skeletal / drug effects*
Myography / methods*
Neuromuscular Blocking Agents*
Signal Processing, Computer-Assisted
Reg. No./Substance:
0/Neuromuscular Blocking Agents

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