A Comparative Study of the Next-Generation TetraGraph® and Mechanomyography Neuromuscular Monitors in Clinical Settings

Starting soon

Conditions studied: Patients Undergoing General Anesthesia

In brief

Background: Neuromuscular monitoring plays a critical role in reducing postoperative residual neuromuscular blockade (PRNB), a significant risk factor for respiratory complications. Despite the availability of various monitoring techniques, the validation of newer devices remains an ongoing challenge. This study compares the performance of the electromyography (EMG)-based New Generation Tetragraph neuromuscular monitor with the gold standard mechanomyography (MMG) device, focusing on their accuracy and reliability in clinical settings. Methods: Twenty cases were conducted during general surgeries requiring neuromuscular relaxation. Ulnar nerve was stimulated via the Tetragraph which detected the compound muscle action potential (CMAP) of adductor pollicis muscle. Simultaneously on the same arm the isometric force of the same stimulated muscle was registrated by the MMG and displayed in the Labchart 8 program. Bland-Altman analysis was used to describe the agreement between devices during distinct phases of neuromuscular blockade. The primary endpoint of the study was the comparison of TOF values of MMG and EMG during induction. In recovery, two groups were made from TOFRs: below and above the recommended muscle recovery to exclude PRNB (TOFR≥90%) (Fuchs-Buder 2023). Additionally, in deeper neuromuscular blockade Train-of-Four Count (TOFC), and Post-Tetanic Count (PTC) values were also analysed.

Key facts

Study ID

NCT07750405

Run by

University of Debrecen

People needed

20

Starts

2026-08-10

Expected to finish

2027-12-31

Last updated by the study team

2026-08-06

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age 18 years or older.
• ASA (American Society of Anesthesiology) physical status I-III.
• Written informed consent.
• The use of a medium-acting muscle relaxant is required for the surgery.

You may not qualify if…

• History of neuromuscular disease (e.g., stroke with hemiplegic symptoms, myasthenia gravis, severe polyneuropathy).
• Use of medications affecting neuromuscular transmission.
• Open wound or rash in the area corresponding to the electrode placement.
• Anticipated difficult intubation.
• Pregnancy, breastfeeding.

Where it is running

• University of Debrecen, Department of Anesthesiology and Intensive Care — Debrecen, Hajdú-Bihar, Hungary

Full record on ClinicalTrials.gov

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