{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:10:32Z","timestamp":1790892632819,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite the potential to improve patient outcomes, quantitative train\u2010of\u2010four (TOF) monitoring has seen limited use in infants and children primarily due to the lack of effective equipment. The current study investigates the feasibility of using an electromyography\u2010based TOF monitor (TetraGraph) in patients &lt;\u20091\u2009year of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Following informed consent, patients &lt;\u20091\u2009year of age presenting for elective surgery that required use of a non\u2010depolarizing neuromuscular blocking agent were enrolled. The TetraGraph electrodes were positioned on the volar aspect of the forearm over the ulnar nerve to supply neurostimulation. Muscle action potentials were recorded at 20\u2010s intervals from the adductor pollicis muscle throughout surgery until tracheal extubation. Data from the monitor were recorded onto the built\u2010in memory card.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study cohort included 49 patients ranging in age from 30\u2009days to 10\u2009months and in weight from 3.1 to 10.3\u2009kg. Effective monitoring was achieved in all 49 patients in the cohort. Based on our clinical practice, rocuronium was the neuromuscular blocking agent used in all patients. Complete data of neuromuscular recording (baseline to recovery) was obtained in 36 patients, as a complete baseline was not obtained in two patients, and 11 patients either did not receive sugammadex based on clinical need or the sensor was removed prior to recovery. Baseline amplitude for muscle action potential was 6.8\u2009\u00b1\u20092.2\u2009mV and recovered to 4.7\u2009\u00b1\u20091.5\u2009mV after reversal of neuromuscular block with sugammadex at completion of the case. The mean baseline TOFr was 99%\u2009\u00b1\u200916.3% and the mean recovered TOFr was 95%\u2009\u00b1\u200910%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients &gt;\u200928\u2009days and &lt;\u20091\u2009year of age, our preliminary data suggest that electromyography\u2010based TOF monitoring can be used effectively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.70043","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:45:31Z","timestamp":1756295131000},"page":"934-939","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intraoperative Electromyographic Monitoring in Children Less Than 1 Year of Age"],"prefix":"10.1111","volume":"35","author":[{"given":"Alicia","family":"Chaney","sequence":"first","affiliation":[{"name":"Heritage College of Osteopathic Medicine \u2013 Dublin Campus  Dublin Ohio USA"},{"name":"Ohio University  Athens Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edison E.","family":"Villalobos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Rice\u2010Weimer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0550-6951","authenticated-orcid":false,"given":"Joseph D.","family":"Tobias","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"},{"name":"Department of Anesthesiology &amp; Pain Medicine, the Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001409"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181e1d94c"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13738"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.02.022"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002387"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000261"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2021.110234"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005386"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.sja_326_22"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.sja_160_23"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mkm032"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004379"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001769"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005051"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005054"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12041"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/78.6.690"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006926"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2023.09.028"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/52.2.205"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.70043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T07:43:53Z","timestamp":1759823033000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.70043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":21,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/pan.70043"],"URL":"https:\/\/doi.org\/10.1111\/pan.70043","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,27]]},"assertion":[{"value":"2025-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}