Comparison of Relaxometry Between Ulnar Nerve and Posterior Tibial Nerve After Cisatracurium Administration Using Electromyography

AuthorPaweł Radkowskien
AuthorStefan Gronden
AuthorHorst Brunneren
AuthorJoanna Wolskaen
AuthorJustyna Dawidowska-Fidrychen
AuthorJakub Ruśćen
AuthorKatarzyna Podhorodeckaen
Issued Date2023-02-28en
AbstractBackground: Electromyography can be used for quantitative neuromuscular monitoring during general anesthesia, mostly using the stimulation train-of-four (TOF) pattern. Relaxometry measures the muscular response of the adductor pollicis muscle to electrical stimulation of the ulnar nerve, which is routinely used in clinical practices for monitoring the neuromuscular block. However, when it is not always possible to be used for all patients, the posterior tibial nerve is a suitable alternative. Objectives: Using electromyography, we compared the neuromuscular block between the ulnar and the posterior tibial nerves. Methods: In this study, the participants were 110 patients who met inclusion criteria and submitted their written consent. Following the administration of cisatracurium intravenously, the patients had relaxometry performed simultaneously on the ulnar and the posterior tibial nerves using electromyography. Results: Eighty-seven patients were included in the final analysis. The onset time was 296 ± 99 s at the ulnar nerve and 346 ± 146 s at the tibial nerve, with a mean difference of -50 s and a standard deviation of 164 s. The 95% limits of agreement ranged from -372 s to 272 s. The relaxation time was 105 ± 26 min at the ulnar nerve and 87 ± 25 min at the tibial nerve, with a mean difference of 18 min and a standard deviation of 20 min. Conclusions: Using electromyography, no statistically significant difference was noticed between the ulnar and the posterior tibial nerve during the neuromuscular block. The onset time and the relaxation time assessed with an electromyogram to compare the stimulation of the ulnar and posterior tibial nerves showed large limits of agreement.en
DOIhttps://doi.org/10.5812/aapm-132866en
URIhttps://brieflands.com/journals/aapm/articles/132866en
KeywordElectromyographyen
KeywordCisatracuriumen
KeywordPosterior Tibial Nerveen
KeywordUlnar Nerveen
KeywordNeuromuscular Monitoringen
KeywordTrain-of-four (TOF) Monitoringen
PublisherBrieflandsen
TitleComparison of Relaxometry Between Ulnar Nerve and Posterior Tibial Nerve After Cisatracurium Administration Using Electromyographyen
TypeResearch Articleen

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