Train-of-four Monitoring Using the Tetragraph Neuromuscular Transmission Monitor and Comparison to Standard (Visual) Train-of-four Assessment With a Peripheral Nerve Stimulator
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Surgery
- Sponsor
- Joseph D. Tobias
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Recovered TOFr (%)
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
This is a prospective study that will evaluate the feasibility of using the Tetragraph Neuromuscular Transmission Monitor in comparison to standard (visual) train-of-four assessment with a peripheral nerve stimulator in pediatric patients undergoing surgery.
Investigators
Joseph D. Tobias
Chairman, Dept. of Anesthesiology & Pain Medicine
Nationwide Children's Hospital
Eligibility Criteria
Inclusion Criteria
- •Pediatric patients requiring anesthetic care and use of neuromuscular blockade
- •Weight range of 20 - 60 kg
Exclusion Criteria
- •Patients with history of a peripheral neurologic or neuropathic disorder
- •Patients in whom the upper extremity cannot be used for TOF monitoring
- •Patients undergoing a surgical procedure in which neuromuscular blockade is not required
- •Edematous patients
Outcomes
Primary Outcomes
Recovered TOFr (%)
Time Frame: At the end of surgery (maximum 7 hours from baseline)
Train of four (TOF) is measured by giving 4 quick electrical pulses to the muscle and counting the number of muscle twitches. Recovered TOFr is the ratio between the fourth twitch of the train of four (TOF) sequence (T4) and the first (T1) after recovery from the neuromuscular blocking agent and then multiplied by 100 to get a percentage. A TOFr greater than or equal to 90% indicates adequate recovery from the neuromuscular block.
Baseline TOFr (%)
Time Frame: Immediately prior to start of surgery
Train of four (TOF) is measured by giving 4 quick electrical pulses to the muscle and counting the number of muscle twitches. Baseline TOFr is the ratio between the fourth twitch of the train of four (TOF) sequence (T4) and the first (T1) prior to administration of the neuromuscular blocking agent and then multiplied by 100 to get a percentage. A lower TOFr equals stronger neuromuscular block and more muscle paralysis.
Secondary Outcomes
- Recovered Amplitude (mV)(At the end of surgery (maximum 7 hours from baseline))
- Rate of Muscle Recovery (Minutes)(At the end of surgery (maximum 7 hours from baseline))
- Baseline Amplitude (mV)(Immediately prior to start of surgery)