Quantitative Twitch Monitoring: What Works Best and How Do We Know?
Andrew Bowdle, Kelly Michaelsen
Abstract
Editorial| October 2021 Quantitative Twitch Monitoring: What Works Best and How Do We Know? Andrew Bowdle, M.D., Ph.D., F.A.S.E.; Andrew Bowdle, M.D., Ph.D., F.A.S.E. From the Department of Anesthesiology, University of Washington, Seattle, Washington Search for other works by this author on: This Site PubMed Google Scholar Kelly Michaelsen, M.D., Ph.D. Kelly Michaelsen, M.D., Ph.D. From the Department of Anesthesiology, University of Washington, Seattle, Washington Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information Accepted for publication July 13, 2021. This editorial accompanies the article on p. 597. This article has a related Infographic on p. A23. Address correspondence to Dr. Bowdle: Anesthesiology October 2021, Vol. 135, 558–561. https://doi.org/10.1097/ALN.0000000000003950 Connected Content Article: Ipsilateral and Simultaneous Comparison of Responses from Acceleromyography- and Electromyography-based Neuromuscular Monitors Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Andrew Bowdle, Kelly Michaelsen; Quantitative Twitch Monitoring: What Works Best and How Do We Know?. Anesthesiology 2021; 135:558–561 doi: https://doi.org/10.1097/ALN.0000000000003950 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: electromyography, induction of neuromuscular blockade, neuromuscular blockade monitoring, noise, train-of-four monitoring, thumb Neuromuscular blocking drugs have been used in anesthesia practice since at least 1942 and have become a routine component of many if not most general anesthetics. Despite this, only in recent times have we focused on ensuring, with a high degree of certainty, that patients do not remain partially paralyzed at the conclusion of an anesthetic. Numerous recent studies have documented that some patients are in fact partially paralyzed for a period of time after anesthesia, sometimes to their detriment.1 We know that subjective twitch monitoring with a peripheral nerve stimulator is not sufficiently sensitive for detection of clinically significant fade in the train-of-four.2 Sugammadex, a highly effective reversal agent for aminosteroid nondepolarizing neuromuscular blocking drugs, and improved quantitative neuromuscular blockade monitors (so-called twitch monitors) have been mobilized in an effort to prevent residual paralysis. In this issue of Anesthesiology, Nemes et al. have compared a... You do not currently have access to this content.