This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hemmerling, T. M. Articles by Beaulieu, P. Search for Related Content PubMed PubMed Citation Articles by Hemmerling, T. M. Articles by Beaulieu, P.

Duration of control stimulation does not affect onset and offset of neuromuscular blockade at the corrugator supercilii muscle measured with phonomyography or acceleromyography

[La durée de la stimulation contrôlée n’a pas d’effet sur le début et la fin du blocage neuromusculaire du muscle sourcilier mesuré par phonomyographie ou accéléromyographie]

Thomas M. Hemmerling, MD DEAA^*, François Donati, MD PhD FRCPC^*, Denis Babin, MSc^* and Pierre Beaulieu, MD PhD

^* From the 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.

Address correspondence to: Dr. Thomas M. Hemmerling, Centre Hospitalier de l’Université de Montréal (CHUM), Hôtel-Dieu, Département d‘anesthésie, 3840, rue Saint-Urbain, Montréal, Québec H2W 1T8, Canada. Phone: 514-890-8000, ext. 14570; E-mail: thomashemmerling{at}hotmail.com

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 mg·kg^–1 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.

This article has been cited by other articles:

				T. M. Hemmerling, G. Michaud, D. Babin, G. Trager, and F. Donati Comparison of phonomyography with balloon pressure mechanomyography to measure contractile force at the corrugator supercilii muscle: [Comparaison de la phonomyographie et de la mecanomyographie avec ballonnet sous pression pour mesurer la force contractile du muscle sourcilier] Can J Anesth, February 1, 2004; 51(2): 116 - 121. [Abstract] [Full Text] [PDF]

				T. M. Hemmerling, G. Michaud, G. Trager, S. Deschamps, D. Babin, and F. Donati Phonomyography and Mechanomyography Can Be Used Interchangeably to Measure Neuromuscular Block at the Adductor Pollicis Muscle Anesth. Analg., February 1, 2004; 98(2): 377 - 381. [Abstract] [Full Text] [PDF]

				T. M. Hemmerling, G. Michaud, S. Deschamps, G. Trager, and K. S. Kim Do We Need to Intubate the Trachea 2 Minutes after Vecuronium 0.1 mg/kg in Elective Surgery? * Response Anesth. Analg., November 1, 2003; 97(5): 1544 - 1545. [Full Text] [PDF]