eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
vol. 52
Original paper

An observational study comparing the performance of TOF-Cuff with TOF-Scan monitoring during anaesthetic induction in clinical routine

Andrew Markle
Katja Horn
JoEllen Welter
Alexander Dullenkopf

Spital Thurgau AG, Frauenfeld, Switzerland
Anaesthesiol Intensive Ther 2020; 52, 3: 181–186
Online publish date: 2020/08/14
View full text Get citation
PlumX metrics:
Neuromuscular monitoring by acceleromyography assesses the effects of non-depolarising neuromuscular blocking agents used during anaesthesia induction to optimise intubation conditions. A new type of neuromuscular monitor, TOF-Cuff, integrates electrode stimulation into a blood pressure monitoring cuff. Comparisons of this device with TOF-Scan, considered a clinical standard acceleromyography device, have not been published.

Material and methods
This prospective, observational study was approved by the Ethics Committee East Switzerland (BASEC-nr. 2016-02044), and patients’ consent was obtained before inclusion. The study’s aim was to compare TOF-Cuff with TOF-Scan by measuring the duration from the administration of a neuromuscular blocking agent to a train-of-four (TOF) ratio of 0%. After anaesthesia induction, atracurium was administered (0.5 mg kg-1) and TOF ratios were recorded every 15 seconds using the two devices simultaneously. Patients were grouped according to body mass index (< or ≥ 30 kg m-2).

Twenty-five non-obese and twenty-five obese patients were included. In non-obese patients, bias was –3 s (± 21.2; limits of agreement –44.7 to 38.4; P = 0.702). In obese patients, bias was –20 s (± 35.0; limits of agreement –88.6 to 48.6; P = 0.0139). Large intra-individual differences of up to 60 seconds were detected even in non-obese patients.

A significant systematic difference in the time to reach a TOF ratio of 0% was found when using the two devices in obese patients. In non-obese and obese patients, there were large intra-individual and clinically relevant differences. The two devices cannot be used interchangeably.


general anaesthesia, patient safety, neuromuscular monitoring

Quick links
© 2023 Termedia Sp. z o.o.
Developed by Bentus.