Comparison of a new neuromuscular transmission monitor compressomyograph with mechanomyograph.
Comparison of a new neuromuscular transmission monitor compressomyograph with mechanomyograph.
复制标题
新型神经肌肉传输监测仪压缩肌描记器与机械肌力描记器的比较。
DOI：
10.1093/bja/aem379
复制
发表时间：
2008
影响因子：
9.8
通讯作者：
Helfried Metzler
中科院分区：
文献类型：
--
作者：
A. Dahaba;H. Bornemann;B. Holst;B. Holst;Georg Wilfinger;Helfried Metzler
背景
我们开发了一种新的神经肌肉传输监测器，压缩肌描记器（CMG，欧洲专利号：EP 06018557.6，美国专利号：US 60/824.541）。这是第一个初步报告比较监测的神经肌肉阻滞CMG和松弛计mechanomyograph（MMG）。
方法
两个监视器被随机分配到16名患者的左手或右手。用T1、以对照反应的百分比表示的四个成串动作的第一次抽搐（TOF）和TOF比率（T4：t1）来评价罗库溴铵0.6 mg kg（-1）产生的神经肌肉阻滞。
结果
CMG监测器未显示松弛前反向衰减（T4>T1）或T1超过100%。平均（SD）起效时间Dur（25）无显著差异（至T1 25%恢复的时间）或持续时间（0.9）（至0.9 TOF比恢复的时间）由CMG [2.4]测量（0.9）、22.6（4.1）、43.1（10.3）min]与MMG [分别为2.1（0.9）、22.9（3.3）、43.3（10.0）min]相比。根据Bland和Altman分析，T1%的偏倚（一致性上限和下限）为-0.3%（+13.4%和-13.8%），TOF比为-0.009（+0.068和-0.085）。CMG预测气管插管完全松弛的敏感性为100%，特异性为75%，预测MMG 0.9 TOF率的敏感性为80%，特异性为86%。
结论
CMG在日常麻醉实践中可能是一种可靠的临床监测器，不需要时间设置或手臂的刚性支撑。
BACKGROUND
We developed a new neuromuscular transmission monitor, the compressomyograph (CMG, European patent number: EP 06018557.6, US patent number: US 60/824.541). This is the first preliminary report comparing neuromuscular block monitored by CMG and the Relaxometer mechanomyograph (MMG).
METHODS
The two monitors were randomly allocated to the left or right hands of 16 patients. T1, first twitch of the train-of-four (TOF) expressed as percentage of control response, and the TOF ratio (T4:t1) were used to evaluate the neuromuscular block produced by rocuronium 0.6 mg kg(-1).
RESULTS
The CMG monitor exhibited no pre-relaxation reverse fade (T4>T1) or T1 exceeding 100%. There was no significant difference in mean (SD) onset time, Dur(25) (time to T1 25% recovery), or Dur(0.9) (time to 0.9 TOF ratio recovery) measured by the CMG [2.4 (0.9), 22.6 (4.1), 43.1 (10.3) min, respectively] compared with MMG [2.1 (0.9), 22.9 (3.3), 43.3 (10.0) min, respectively]. According to Bland and Altman analysis, the bias (upper and lower limits of agreement) for T1% was -0.3% (+13.4% and -13.8%) and for TOF ratio was -0.009 (+0.068 and -0.085). CMG showed 100% sensitivity and 75% specificity in indicating full relaxation for tracheal intubation, and 80% sensitivity with 86% specificity in predicting MMG 0.9 TOF ratio.
CONCLUSIONS
The CMG could be a reliable clinical monitor in the daily anaesthesia practice that does not require time to set up or rigid support of the arm.