{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T21:50:55Z","timestamp":1787003455246,"version":"build-2736575974"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Acceleromyography at the adductor pollicis located in a distal part of the body may not reflect the degree of neuromuscular blockade (NMB) at the proximally located muscles manipulated during lumbar surgery. We investigated the usefulness and characteristics of acceleromyographic monitoring at the trapezius for providing moderate NMB during lumbar surgery. Fifty patients were randomized to maintain a train-of-four count 1\u20133 using acceleromyography at the adductor pollicis (group A; n\u2009=\u200925) or the trapezius (group T; n\u2009=\u200925). Total rocuronium dose administered intraoperatively [mean\u2009\u00b1\u2009SD, 106.4\u2009\u00b1\u200931.3 vs. 74.1\u2009\u00b1\u200917.6\u00a0mg;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001] and surgical satisfaction (median [IQR], 7 [5\u20138] vs. 5 [4\u20135];\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001) were significantly higher in group T than group A. Lumbar retractor pressure (88.9\u2009\u00b1\u200912.0 vs. 98.0\u2009\u00b1\u20097.8\u00a0mmHg;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.003) and lumbar muscle tone in group T were significantly lower than group A. Time to maximum block with an intubating dose was significantly shorter in group T than group A (44 [37\u201354] vs. 60 [55\u201365] sec;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Other outcomes were comparable. Acceleromyography at the trapezius muscle during lumbar surgery required a higher rocuronium dose for moderate NMB than the adductor pollicis muscle, thereby the consequent deeper NMB provided better surgical conditions. Trapezius as proximal muscle may better reflect surgical conditions of spine muscle.\n                  <\/jats:p>","DOI":"10.1038\/s41598-021-94062-2","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T06:03:50Z","timestamp":1626329030000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison between the trapezius and adductor pollicis muscles as an acceleromyography monitoring site for moderate neuromuscular blockade during lumbar surgery"],"prefix":"10.1038","volume":"11","author":[{"given":"Seok Kyeong","family":"Oh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangwoo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Gun","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Sung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heezoo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myoung Hoon","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"94062_CR1","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1097\/EJA.0000000000000094","volume":"31","author":"PE Dubois","year":"2014","unstructured":"Dubois, P. E. et al. Deep neuromuscular block improves surgical conditions during laparoscopic hysterectomy: a randomised controlled trial. Eur. J. Anaesthesiol. 31, 430\u2013436 (2014).","journal-title":"Eur. J. Anaesthesiol."},{"key":"94062_CR2","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1093\/bja\/aet377","volume":"112","author":"CH Martini","year":"2014","unstructured":"Martini, C. H., Boon, M., Bevers, R. F., Aarts, L. P. & Dahan, A. Evaluation of surgical conditions during laparoscopic surgery in patients with moderate vs deep neuromuscular block. Br. J. Anaesth. 112, 498\u2013505 (2014).","journal-title":"Br. J. Anaesth."},{"key":"94062_CR3","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1093\/bja\/aex116","volume":"118","author":"MH Bruintjes","year":"2017","unstructured":"Bruintjes, M. H. et al. Deep neuromuscular block to optimize surgical space conditions during laparoscopic surgery: a systematic review and meta-analysis. Br. J. Anaesth. 118, 834\u2013842 (2017).","journal-title":"Br. J. Anaesth."},{"key":"94062_CR4","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1213\/ANE.0000000000000316","volume":"119","author":"AK Staehr-Rye","year":"2014","unstructured":"Staehr-Rye, A. K. et al. Surgical space conditions during low-pressure laparoscopic cholecystectomy with deep versus moderate neuromuscular blockade: a randomized clinical study. Anesth. Analg. 119, 1084\u20131092 (2014).","journal-title":"Anesth. Analg."},{"key":"94062_CR5","doi-asserted-by":"publisher","first-page":"e0167907","DOI":"10.1371\/journal.pone.0167907","volume":"11","author":"B Torensma","year":"2016","unstructured":"Torensma, B. et al. Deep neuromuscular block improves surgical conditions during bariatric surgery and reduces postoperative pain: a randomized double blind controlled trial. PLoS ONE 11, e0167907 (2016).","journal-title":"PLoS ONE"},{"issue":"Suppl 1","key":"94062_CR6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/anae.13738","volume":"72","author":"M Naguib","year":"2017","unstructured":"Naguib, M., Brull, S. J. & Johnson, K. B. Conceptual and technical insights into the basis of neuromuscular monitoring. Anaesthesia 72(Suppl 1), 16\u201337 (2017).","journal-title":"Anaesthesia"},{"key":"94062_CR7","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1034\/j.1399-6576.2002.460912.x","volume":"46","author":"PB Larsen","year":"2002","unstructured":"Larsen, P. B. et al. Acceleromyography of the orbicularis oculi muscle II: comparing the orbicularis oculi and adductor pollicis muscles. Acta Anaesthesiol. Scand. 46, 1131\u20131136 (2002).","journal-title":"Acta Anaesthesiol. Scand."},{"key":"94062_CR8","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1097\/ALN.0b013e31826f8fdd","volume":"117","author":"SR Thilen","year":"2012","unstructured":"Thilen, S. R. et al. Intraoperative neuromuscular monitoring site and residual paralysis. Anesthesiology 117, 964\u2013972 (2012).","journal-title":"Anesthesiology"},{"key":"94062_CR9","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1097\/00000542-199409000-00010","volume":"81","author":"JP Cantineau","year":"1994","unstructured":"Cantineau, J. P., Porte, F., d\u2019Honneur, G. & Duvaldestin, P. Neuromuscular effects of rocuronium on the diaphragm and adductor pollicis muscles in anesthetized patients. Anesthesiology 81, 585\u2013590 (1994).","journal-title":"Anesthesiology"},{"key":"94062_CR10","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1007\/s12630-016-0609-y","volume":"63","author":"S Soltesz","year":"2016","unstructured":"Soltesz, S., Stark, C., No\u00e9, K. G., Anapolski, M. & Mencke, T. Monitoring recovery from rocuronium-induced neuromuscular block using acceleromyography at the trapezius versus the adductor pollicis muscle: an observational trial. Can. J. Anaesth. 63, 709\u2013717 (2016).","journal-title":"Can. J. Anaesth."},{"key":"94062_CR11","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12871-017-0401-8","volume":"17","author":"S Soltesz","year":"2017","unstructured":"Soltesz, S., Stark, C., No\u00e9, K. G., Anapolski, M. & Mencke, T. Comparison of the trapezius and the adductor pollicis muscle as predictor of good intubating conditions: a randomized controlled trial. BMC Anesthesiol. 17, 106 (2017).","journal-title":"BMC Anesthesiol."},{"key":"94062_CR12","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1111\/j.1399-6576.2007.01352.x","volume":"51","author":"T Fuchs-Buder","year":"2007","unstructured":"Fuchs-Buder, T. et al. Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision. Acta Anaesthesiol. Scand. 51, 789\u2013808 (2007).","journal-title":"Acta Anaesthesiol. Scand."},{"key":"94062_CR13","doi-asserted-by":"publisher","first-page":"498","DOI":"10.3390\/jcm8040498","volume":"8","author":"SK Oh","year":"2019","unstructured":"Oh, S. K. et al. Comparison of operating conditions, postoperative pain and recovery, and overall satisfaction of surgeons with deep vs no neuromuscular blockade for spinal surgery under general anesthesia: a prospective randomized controlled trial. J. Clin. Med. 8, 498 (2019).","journal-title":"J. Clin. Med."},{"key":"94062_CR14","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1093\/bja\/aei273","volume":"96","author":"T Suzuki","year":"2006","unstructured":"Suzuki, T., Fukano, N., Kitajima, O., Saeki, S. & Ogawa, S. Normalization of acceleromyographic train-of-four ratio by baseline value for detecting residual neuromuscular block. Br. J. Anaesth. 96, 44\u201347 (2006).","journal-title":"Br. J. Anaesth."},{"key":"94062_CR15","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1093\/bja\/aeg264","volume":"91","author":"B Du Manoir","year":"2003","unstructured":"Du Manoir, B. et al. Randomized prospective study of the analgesic effect of nefopam after orthopaedic surgery. Br. J. Anaesth. 91, 836\u2013841 (2003).","journal-title":"Br. J. Anaesth."},{"key":"94062_CR16","doi-asserted-by":"publisher","first-page":"110","DOI":"10.3344\/kjp.2016.29.2.110","volume":"29","author":"JY Moon","year":"2016","unstructured":"Moon, J. Y. et al. The effect of nefopam on postoperative fentanyl consumption: a randomized, double-blind study.  Korean J. Pain 29, 110\u2013118 (2016).","journal-title":"Korean J. Pain"},{"key":"94062_CR17","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.gie.2008.02.011","volume":"68","author":"DJ Pambianco","year":"2008","unstructured":"Pambianco, D. J., Whitten, C. J., Moerman, A., Struys, M. M. & Martin, J. F. An assessment of computer-assisted personalized sedation: a sedation delivery system to administer propofol for gastrointestinal endoscopy. Gastrointest. Endosc. 68, 542\u2013547 (2008).","journal-title":"Gastrointest. Endosc."},{"key":"94062_CR18","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/BF03193146","volume":"39","author":"F Faul","year":"2007","unstructured":"Faul, F., Erdfelder, E., Lang, A. G. & Buchner, A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 39, 175\u2013191 (2007).","journal-title":"Behav. Res. Methods"},{"key":"94062_CR19","doi-asserted-by":"publisher","first-page":"353","DOI":"10.4097\/kja.d.18.00242","volume":"71","author":"S Lee","year":"2018","unstructured":"Lee, S. & Lee, D. K. What is the proper way to apply the multiple comparison test?. Korean J. Anesthesiol. 71, 353\u2013360 (2018).","journal-title":"Korean J. Anesthesiol."},{"key":"94062_CR20","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1097\/00000542-200112000-00008","volume":"95","author":"K Kirov","year":"2001","unstructured":"Kirov, K., Motamed, C. & Dhonneur, G. Differential sensitivity of abdominal muscles and the diaphragm to mivacurium: an electromyographic study. Anesthesiology 95, 1323\u20131328 (2001).","journal-title":"Anesthesiology"},{"key":"94062_CR21","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1007\/BF03008227","volume":"39","author":"C Meistelman","year":"1992","unstructured":"Meistelman, C., Plaud, B. & Donati, F. Rocuronium (ORG 9426) neuromuscular blockade at the adductor muscles of the larynx and adductor pollicis in humans. Can. J. Anaesth. 39, 665\u2013669 (1992).","journal-title":"Can. J. Anaesth."},{"key":"94062_CR22","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1097\/00000542-197210000-00012","volume":"37","author":"BE Waud","year":"1972","unstructured":"Waud, B. E. & Waud, D. R. The margin of safety of neuromuscular transmission in the muscle of the diaphragm. Anesthesiology 37, 417\u2013422 (1972).","journal-title":"Anesthesiology"},{"key":"94062_CR23","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/EJA.0000000000001135","volume":"37","author":"WS Kang","year":"2020","unstructured":"Kang, W. S. et al. Deep neuromuscular blockade during spinal surgery reduces intra-operative blood loss: a randomised clinical trial. Eur. J. Anaesthesiol. 37, 187\u2013195 (2020).","journal-title":"Eur. J. Anaesthesiol."},{"key":"94062_CR24","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1093\/bja\/aep064","volume":"102","author":"HJ Lee","year":"2009","unstructured":"Lee, H. J., Kim, K. S., Jeong, J. S., Cheong, M. A. & Shim, J. C. Comparison of the adductor pollicis, orbicularis oculi, and corrugator supercilii as indicators of adequacy of muscle relaxation for tracheal intubation. Br. J. Anaesth. 102, 869\u2013874 (2009).","journal-title":"Br. J. Anaesth."},{"key":"94062_CR25","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1097\/EJA.0b013e3283625039","volume":"30","author":"HJ Lee","year":"2013","unstructured":"Lee, H. J., Kim, K. S., Jeong, J. S., Shim, J. C. & Oh, Y. N. Comparison of four facial muscles, orbicularis oculi, corrugator supercilii, masseter or mylohyoid, as best predictor of good conditions for intubation: a randomised blinded trial. Eur. J. Anaesthesiol. 30, 556\u2013562 (2013).","journal-title":"Eur. J. Anaesthesiol."},{"key":"94062_CR26","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/00007632-199802010-00014","volume":"23","author":"JR Styf","year":"1998","unstructured":"Styf, J. R. & Will\u00e9n, J. The effects of external compression by three different retractors on pressure in the erector spine muscles during and after posterior lumbar spine surgery in humans. Spine (Phila Pa 1976) 23, 354\u2013358 (1998).","journal-title":"Spine (Phila Pa 1976)"},{"key":"94062_CR27","doi-asserted-by":"publisher","first-page":"E1050","DOI":"10.1097\/BRS.0b013e3181edea9c","volume":"35","author":"G Datta","year":"2010","unstructured":"Datta, G., McGregor, A., Medhi-Zadeh, S., Khalil, N. & Hughes, S. P. The impact of intermittent retraction on paraspinal muscle function during lumbar surgery. Spine (Phila, PA) 35, E1050\u2013E1057 (2010).","journal-title":"Spine (Phila, PA)"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-94062-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-94062-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-94062-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T06:18:55Z","timestamp":1670048335000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-94062-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,15]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["94062"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-94062-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-275609\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,15]]},"assertion":[{"value":"25 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14568"}}