The Feasibility of the Posterior Tibial Nerve-flexor Hallucis Brevis Pathway Applied in Neuromuscular Monitoring: a Multicentric, Controlled, and Prospective Clinical Trial

Overview

Journal PeerJ

Specialties Biology
Environmental Health
General Medicine

Date 2024 Apr 1

PMID 38560472

Authors

Weiqiang Chen

Zhijian Chen

Fang Cheng

Zhuodan Wang

Juan Li

Shangrong Li

Hanbin Xie

Affiliations

Soon will be listed here.

Abstract

This study aimed to investigate the clinical viability of utilizing the flexor hallucis brevis as an alternative site for neuromuscular monitoring compared to the conventional adductor pollicis. Patients were recruited from three medical centers. Cis-atracurium was administered, and two monitors were employed independently to assess neuromuscular blockade of the adductor pollicis and the ipsilateral flexor hallucis brevis, following a train of four (TOF) pattern until TOF ratios exceeded 0.9 or until the conclusion of surgery. Statistical analysis revealed significant differences in onset time, duration of no-twitch response, spontaneous recovery time, and total monitoring time between the two sites, with mean differences of -53.54 s, -2.49, 3.22, and 5.89 min, respectively ( < 0.001).The posterior tibial nerve-flexor hallucis brevis pathway presents a promising alternative for neuromuscular monitoring during anesthesia maintenance. Further investigation is warranted to explore its utility in anesthesia induction and recovery. : The trial was registered at www.chictr.org.cn (20/11/2018, ChiCTR1800019651).

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