Phonomyography and Mechanomyography Can Be Used Interchangeably to Measure Neuromuscular Block at the Adductor Pollicis Muscle

Abstract

Mechanomyography and phonomyography (PMG), a novel method of monitoring neuromuscular blockade (NMB) by recording low-frequency sounds emitted by muscle contraction, can be used interchangeably to determine NMB at the adductor pollicis muscle. PMG is easier to apply, does not need a special monitoring board and could be a reliable monitor to determine NMB in daily routine.

A more precise, repeatable and diagnostic alternative to surface electromyography – an appraisal of the clinical utility of acoustic myography

“…In the past mechanomyography, sonomyography and other such techniques were tried and tested, but were found to suffer like sEMG from noise and interference, or simply prove to be insensitive to actual muscle frequencies, making them too imprecise to be of use as a diagnostic technique of muscle contractions (Hemmerling et al, 2004;Shinohara & Søgaard, 2006;Beck et al, 2010;Herda et al, 2010;Tian et al, 2010;Alves & Chau, 2011;Qi et al, 2011). For example, early AMG recordings were often obtained using piezoelectric microphones with an air cavity between the skin and the sensor, a configuration that was subsequently shown with the aid of accelerometers to be incapable of detecting the lower frequency range of muscle contractions (Barry et al, 1985).…”

“…Many studies have attempted to measure muscle contractions with the aid of accelerometers attached to the skin above the muscle of interest (Bajaj et al, 2002;Hemmerling et al, 2004;Beck et al, 2010;Guo et al, 2010;Alves & Chau, 2011), and whilst such a sensor can and does measure these pressure waves resulting from muscle fibre contraction, they also pick up the movements of the limb as it accelerates, decelerates, is lifted or lowered and particularly as it impacts a hard surface (e.g. Many studies have attempted to measure muscle contractions with the aid of accelerometers attached to the skin above the muscle of interest (Bajaj et al, 2002;Hemmerling et al, 2004;Beck et al, 2010;Guo et al, 2010;Alves & Chau, 2011), and whilst such a sensor can and does measure these pressure waves resulting from muscle fibre contraction, they also pick up the movements of the limb as it accelerates, decelerates, is lifted or lowered and particularly as it impacts a hard surface (e.g.…”

“…Many of the early AMG studies were undertaken with a great deal of care (Stokes & Blythe, 2001;Bajaj et al, 2002;Hemmerling et al, 2004;Guo et al, 2010); however, a number of limiting factors still remain unresolved, namely the speed of sampling (on occasions too low), the size and weight of the equipment used (too big and heavypreventing patients to move freely or wander outside of a laboratory environment), noise correction and, finally, the development of a better means of sensor/skin contact reducing sensor-airtissue signal loss.…”

Advances and perspectives of mechanomyography

“…MMG has applications in the clinical assessment of neuromuscular tissue in animals (Staals et al, 2011), as can be found in the study of Hemmerling et al (2004), which states that MMG and phonomyography (condenser microphone) are viable for determining the neuromuscular blockade at the adductor pollicis muscle using the train-of-four method (electrical stimulation applied in nerves during anesthesia). Other studies (Fukano et al, 2011;Varposhti et al, 2011) used MMG and the train-of-four method with the same objective: to evaluate the neuromuscular blockade with anesthetics.…”

“…The technique, coined mechanomyography (MMG), measures the skin oscillations of contracting muscles (Orizio, 1993). This type of measurement is also called soundmyography (Orizio et al, 1991), phonomyography (Hemmerling et al, 2004), acousticmyography (Barry et al, 1985), vibromyography (Cole et al, 2006;Vaz et al, 1997), acceleromyography (Fukano et al, 2011;Schreiber et al, 2011;Varposhti et al, 2011), and mechanomyogram (Alves and Chau, 2010).…”