- Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi
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- Correlation of Train Of Four with Frontal EMG measured by Patient State Index monitor in extubation ...
Correlation of Train Of Four with Frontal EMG measured by Patient State Index monitor in extubation phase of general anesthesia
Authors : Hakan Gökalp Taş, Didem Onk, Ufuk Kuyrukluyildiz, Süheyla Ünver
Pages : 173-177
Doi:10.20492/aeahtd.1378686
View : 9 | Download : 30
Publication Date : 2024-01-21
Article Type : Research
Abstract :Aim: The routine use of processed electroencephalography (EEG) monitoring (like Patient State Index-PSI) and train of four (TOF) monitors is recommended for patients under general anesthesia. The aim of our study is to examine the correlation of the frontal electromyography (EMG) parameter, which can evaluate muscle strength in PSI monitoring, with the measured TOF value, so that both muscle strength and anesthetic depth can be evaluated with a single monitoring technique. Materials and methods: One hundred patients aged 18-65 years old, American Society of Anesthesiologists risk score (ASA) I-III who underwent general anesthesia that lasted more than 1 hour were included in our study. Following the end of the procedure, PSI and EMG values were recorded at TOF of 0%, 25%, 50%, 75% and 90% time points. When TOF was 90%, patients were extubated. Final measurements for TOF, PSI and EMG were recorded 5 minutes after extubation. Results: A strong positive relationship was found both between TOF and PSI (r=0.74 p<0.001), and between TOF and EMG (r=0.76 p<0.001). When receiver operating characteristic (ROC) analysis was applied to TOF and EMG and PSI variables, the extubation cut-off point for EMG was 24.5 (Area Under the Curve (AUC):0.852, p<0.001) while PSI showed 60.5 (AUC:0.834, p<0.001) which were both statistically significant. Conclusions: Results demonstrate a strong positive correlation between TOF and frontal EMG values. As a result of the ROC analysis, our study suggests that a frontal EMG value above 24.5 or a PSI value above 60 is supportive when making the extubation decision. Key Words: Accelerometry; Anesthesia, General; Anesthesia Recovery Period; Electromyography; Neuromuscular MonitoringKeywords : Akselerometre, Genel Anestezi, Anestezi Derlenme Dönemi, Elektromiyografi, Nöromusküler Monitörizasyon