Observational studyPaediatric anaesthesia2026
Neuromuscular Monitoring of Rocuronium 0.6 mg/kg in Children Aged 3-24 Months With Electromyography and Acceleromyography: An Observational Study.
Observational study in Paediatric anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06409260 (Objective Neuromuscular Monitoring in Children), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Objective Neuromuscular Monitoring in Children (6 Months - 2 Years) With Electromyography and Acceleromyography: A Randomized Study
Who cites it
1 citing paper in PubMed.
- Monitoring Neuromuscular Block in Infants and Children: Is It Time? Which Monitor Should I Use?Paediatric anaesthesia · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundObjective neuromuscular monitoring is essential to prevent residual neuromuscular block in patients receiving neuromuscular blocking agents. However, the small size of pediatric hands and the lack of appropriately sized neuromuscular equipment have made quantitative neuromuscular monitoring at the ulnar nerve (UN) difficult. In such cases, the tibial nerve (TN) can serve as an alternative site. This study aimed to compare train-of-four (TOF) monitoring using acceleromyography (AMG) and electromyography (EMG) at the TN and UN in children aged 3-24 months. We hypothesized that the time to reach a train-of-four ratio (TOFR) ≥ 0.9 would be shorter with AMG compared to EMG.
methodsIn this observational study, a total of 107 pediatric patients scheduled to elective surgery under general anesthesia with rocuronium 0.6 mg/kg were included. Patients were allocated to either bilateral tibial nerve (TN) or bilateral ulnar nerve (UN) monitoring using AMG and EMG. The primary outcome was time to TOFR ≥ 0.9. Other outcomes were time to TOFC = 0 (onset); reappearance of post tetanic count (PTC) = 1, TOFC = 1, TOFC = 2, and symptoms of residual neuromuscular block.
resultsFifty patients were bilaterally monitored at TN and 50 patients were bilaterally monitored at UN. At TN time to TOFR ≥ 0.9 was 81 min (SD 29) with AMG and 112 min (SD 34) with EMG with a mean difference of 34 min (95% CI: 29-39; p < 0.0001). At UN time to TOFR ≥ 0.9 was 71 min (SD 29) with AMG and 82 min (SD 28) with EMG, with a mean difference of 11 min (95% CI: 6-15; p < 0.0001). Seventeen patients exhibited symptoms of residual neuromuscular block.
conclusionTime to TOFR ≥ 0.9 after rocuronium 0.6 mg/kg in children aged 3-24 months was significantly shorter with AMG compared to EMG at both the UN and TN. AMG may underestimate the duration of action.
trial registrationClinicalTrials.gov identifier: NCT06409260.
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