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001-es BibID:BIBFORM087868
035-os BibID:(WoS)000529444900043 (Scopus)85082146494
Első szerző:Nemes Réka (aneszteziológus, intenzív terápiás szakorvos)
Cím:Awake Volunteer Pain Scores During Neuromuscular Monitoring / Réka Nemes, György Nagy, Glenn S. Murphy, Ilana I. Logvinov, Béla Fülesdi, J. Ross Renew
Dátum:2020
ISSN:0003-2999
Megjegyzések:BACKGROUND: There is a need for easy to use, reliable neuromuscular monitors (NMMs). This multicenter, prospective, unblinded study compared the discomfort associated with neurostimulation in unmedicated healthy volunteers when using the new electromyography (EMG)-based TetraGraph and acceleromyography (AMG)-based TOF-Watch NMMs. The secondary aim was to compare the repeatability of the train-of-four (TOF) ratios (TOFRs) obtained with the 2 devices. METHODS: The TOF measurements of 135 volunteers from 3 university hospitals were analyzed (age: 38.3 ? 12 years [mean ? standard deviation [SD]]; male/female ratio = 63:72). The left or right ulnar nerve was stimulated at the wrist in TOF mode with 20, 30, 40, and 50 mA stimulating current intensities with both devices in random order. The TOF-Watch used standard electrocardiography (ECG) electrodes (Red Dot; 3M Health Care) for nerve stimulation. The stimulating surface area of 1 ECG electrode is 113 mm2. The piezoelectric probe was attached to the thumb, and a hand adapter was used to ensure consistency of AMG measurements. The TetraGraph uses proprietary surface strip electrodes for nerve stimulation and muscle action potential recording, whose stimulating surface area is roughly twice as big as that of standard ECG electrodes (228.5 mm2). The volunteers were asked to rate the discomfort associated with neurostimulation on a 0?10 verbal numerical rating scale (VNRS) score anchored with 0 (no pain) and 10 (worst pain ever experienced). A linear mixed-effects model was used to evaluate the difference in VNRS scores between devices. P <.05 was accepted as the level of significance. RESULTS: In the linear mixed-effects model, there were no differences in VNRS scores between devices at any of the stimulating current intensities, P = .38. The median (range) VNRS scores obtained with TOF-Watch and TetraGraph devices were 2 (0?7) vs 2 (0?8) at 20 mA, 3 (1?9) vs 3 (1?9) at 30 mA, 5 (1?10) vs 5 (1?10) at 40 mA, and 5 (1?10) vs 6 (1?10) at 50 mA stimulating current intensities. The mean of the 1469 TOFRs obtained with TetraGraph was 100.43% ? 7.74% (standard error = 0.2%). Due to technical difficulties, the repeatability of the TOFRs could not be determined. CONCLUSIONS: Despite the different size and design of the stimulating electrodes, the 2 NMMs caused the same level of discomfort in unmedicated healthy volunteers.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Anesthesia and Analgesia. - 130 : 4 (2020), p. 941-948. -
További szerzők:Nagy György (1986-) (aneszteziológus, intenzív terápiás szakorvos) Murphy, Glenn S. Logvinov, Ilana I. Fülesdi Béla (1961-) (aneszteziológus) Renew, J. Ross
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Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:BIBFORM094394
035-os BibID:(cikkazonosító)110234
Első szerző:Renew, J. Ross
Cím:Comparison of the TetraGraph and TOFscan for monitoring recovery from neuromuscular blockade in the Post Anesthesia Care Unit. / Renew J. R., Hernandez-Torres V., Logvinov I., Nemes R., Nagy G., Li Z., Watt L., Murphy G. S.
Dátum:2021
ISSN:0952-8180
Megjegyzések:Study objective: Comparison of the TetraGraph (TG) and TOFscan (TS) for monitoring recovery from neuromuscular blockade in the Post Anesthesia Care Unit (PACU). Design: Randomized, multicenter trial. Setting: PACU in three tertiary care hospitals. Patients: 120 patients (40 per site) receiving neuromuscular blockade during elective surgery. Interventions: Patients were enrolled preoperatively and intraoperative neuromuscular blockade management was at the discretion of the anesthesiologist. Upon arrival to the PACU, patients were randomized to have either TG or TS placed on their dominant hand. The alternate device (TS or TG) was placed on the nondominant hand. Following simultaneous ulnar nerve stimulation on each arm, the response of the adductor pollicis was measured. Measurements: Train-of-four ratios (TOFRs) were obtained upon arrival to the PACU (t = 0), after 5 min (t = + 5) and after +10 min (t = + 10). Main results: There was there was no significant difference in the mean TOFRs obtained with the TG and TS at t = 0 (0.97 ? 0.18 vs 0.94 ? 0.13, P = 0.06, respectively) and t = + 5 (0.96 ? 0.20 vs 0.95 ? 0.12, P = 0.29, respectively). At (t = + 10), there was a statistically significant difference in mean TOFRs obtained with the TG and TS, (0.99 ? 0.14 vs 0.94 ? 0.12, P < 0.001, respectively). The bias between devices at t = 0 was estimated to be 0.03 (95% CI, ?? 0.29 to 0.35, P = 0.26); at t = + 5 min, it was estimated to be 0.02 (95% CI, ?? 0.36 to 0.40, P = 0.54); and at t = +10 min, it was estimated to be 0.05 (95% CI, ?? 0.25 to 0.36, P = 0.77). Conclusions: TS and TG provide interchangeable quantitative measurements once the TOF ratio has returned to a value of 0.90 or greater in the PACU.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Journal Of Clinical Anesthesia. - 71 (2021), p. 1-6. -
További szerzők:Hernandez-Torres, Vivian Logvinov, Ilana I. Nemes Réka (1985-) (aneszteziológus, intenzív terápiás szakorvos) Nagy György (1986-) (aneszteziológus, intenzív terápiás szakorvos) Li, Zhuo Watt, Liah Murphy, Glenn S.
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DOI
Intézményi repozitóriumban (DEA) tárolt változat
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