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01-02-2019 | Original Article

Efficiency of the TOF-Cuff™ for the evaluation of rocuronium-induced neuromuscular block and its reversal with sugammadex: a comparative study vs. acceleromyography

Authors: Yasuhito Kameyama, Shunichi Takagi, Katsuhisa Seto, Ichie Kajiwara, Miori Goto, Osamu Kitajima, Takahiro Suzuki

Published in: Journal of Anesthesia | Issue 1/2019

Abstract

Purpose

The aim of this study was to compare TOF-Cuff™ (TOF-C) and TOF-Watch™ (TOF-W) data following rocuronium-induced neuromuscular block and its reversal with sugammadex.

Methods

Twenty elderly patients aged 68–82 years scheduled for surgery under general anesthesia were enrolled in this study. After induction of anesthesia, neuromuscular block resulting from administration of 0.6 mg/kg rocuronium was concurrently evaluated using TOF-C and TOF-W. The onset of neuromuscular block and duration until the first twitch response following post-tetanic count (PTC) and 2 Hz train-of-four (TOF) stimulation reappeared were evaluated. When the response to the TOF stimulus was detected with both monitors, additional doses of rocuronium were administered to maintain the neuromuscular block. After surgery, 2 mg/kg sugammadex was administered when 1–2 TOF twitches were observed with the TOF-W and the time required for facilitated recovery to a TOF ratio of > 0.9 was assessed.

Results

Regression analyses revealed no statistically significant differences in the mean [SD] onset of rocuronium-induced neuromuscular block [127.8 (27.2) s, 123.5 (30.5) s], time to recovery of the first PTC twitch [23.9 (8.0) min, 25.4 (8.6) min], time to recovery of the first twitch with TOF stimulation [37.2 (8.8) min, 38.9 (11.1) min] and time to adequate reversal with sugammadex [139.2 (30.6) s, 151.8 (31.5) s] between TOF-C and TOF-W, respectively. Bland–Altman analyses also showed acceptable ranges of the biases and limits of agreement between the two methods.

Conclusions

TOF-C may be clinically applicable for the evaluation of both the depth of neuromuscular block and restoration of neuromuscular function.

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Title: Efficiency of the TOF-Cuff™ for the evaluation of rocuronium-induced neuromuscular block and its reversal with sugammadex: a comparative study vs. acceleromyography
Authors: Yasuhito Kameyama
Shunichi Takagi
Katsuhisa Seto
Ichie Kajiwara
Miori Goto
Osamu Kitajima
Takahiro Suzuki
Publication date: 01-02-2019
Publisher: Springer Japan
Published in: Journal of Anesthesia / Issue 1/2019
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-018-2587-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficiency of the TOF-Cuff™ for the evaluation of rocuronium-induced neuromuscular block and its reversal with sugammadex: a comparative study vs. acceleromyography

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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