Shortening of the twitch stabilization period by tetanic stimulation in acceleromyography in infants, children and young adults (STSTS-Study): a prospective randomised, controlled trial
| Autor: | Markus Werkmann, Bernhard M. Graf, Timo Seyfried, Barbara Sinner, Christoph Unterbuchner, Raphael Ziegleder, Florian Zeman, Stephanie Kraus, Manfred Blobner, Thomas Metterlein |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Health Informatics Anesthesia General Critical Care and Intensive Care Medicine law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Age groups Randomized controlled trial 030202 anesthesiology law Humans Medicine Prospective Studies Young adult Child Monitoring Physiologic business.industry Infant 030208 emergency & critical care medicine Electric Stimulation Anesthesiology and Pain Medicine Tetanic stimulation business |
| Zdroj: | Journal of Clinical Monitoring and Computing. 34:1343-1349 |
| ISSN: | 1573-2614 1387-1307 |
| DOI: | 10.1007/s10877-019-00435-4 |
| Popis: | Acceleromyography is characterised by an increase of the twitch response T1 (first twitch of the train-of-four [TOF]) during first 30 min of monitoring known as the staircase phenomenon. In adults the staircase phenomenon can be avoided by tetanic prestimulation. This study examined, if tetanic prestimulation eliminates the staircase phenomenon in children. After written informed consent, the neuromuscular function of 80 children, 10 in each age group ( 6 months, 6-12 months, 12-24 months, 2-3 years, 3-6 years, 6-12 years, 12-18 years, and ≥ 18 years) was measured on both arms simultaneously over 30 min under general anaesthesia. The ulnaris nerve was stimulated using the TOF technique every 15 s. The twitch response (T1, TOF ratio [TOFR]) was measured by acceleromyography. Before calibration, tetanic prestimmulation (50 Hz for 5 s) was administered to one randomly selected arm. The effect of tetanic prestimulation and age was analysed using general linear models based on the normalized T1 and TOFRs of both arms. Tetanic prestimulation significantly affected T1 values avoiding the staircase phenomenon (p 0.0001). After 5.8 min [1.0-17.2 min] the normalized T1 values increased to 117% [102-147%] without prestimulation (p 0.0001) independent of the age group (p = 0.539). The normalized TOFR was stable throughout the observation period of 30 min 100% [95-107%]. Infants ( 12 weeks), children, and young adults ( 18 years) develop similar characteristics of the staircase phenomenon than adults. Tetanic prestimulation prevents the staircase phenomenon in these age groups. The stability of the TOFR reading confirms its value to monitor neuromuscular function over time.Registration: The study was registered as NCT02552875 on Clinical Trials.gov on July 29, 2014. |
| Databáze: | OpenAIRE |
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