Comparing Two Electromyography Devices to Monitor Deep Neuromuscular Block During Laparoscopic, Robotic, or Thoracic Video-Assisted Surgeries

What this Trial Is About

Researchers are comparing two electromyography EMG devices, the TetraGraph and TwitchView, to monitor deep neuromuscular blockade during elective laparoscopic, robotic, or thoracic video-assisted surgeries. The study aims to evaluate how well each device detects spontaneous diaphragmatic movements and breath-initiation efforts, which indicate the depth of muscle relaxation during surgery. This intraoperative device comparison trial uses a randomized, double-masked design to assess monitoring performance under standard anesthesia care. Participants will have both devices placed on opposite hands, with the dominant hand device guiding neuromuscular blockade management. The devices measure muscle responses using Train-of-Four and post-tetanic count methods continuously during surgery. Standard anesthesia protocols, including rocuronium administration and sugammadex reversal, are maintained. Data collected include device outputs, neuromuscular blocking agent dosing, physiological parameters, and clinical observations. After surgery, providers will complete surveys to assess device usability and workflow integration. Participants undergo assessments during surgery, including neuromuscular function monitoring at various time points from baseline through emergence from anesthesia. Researchers will track diaphragmatic movements, breath efforts, intubation difficulty, vocal cord visibility and movement, recovery times, and usability scores. All data are gathered without altering standard patient care. The study runs from February 2026 to August 2028, with participant involvement limited to the surgery and immediate postoperative period.

Comparison of Two Quantitative EMG Monitors for Deep Neuromuscular Block in Laparoscopic/Robotic and VATS Surgery