{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:59:53Z","timestamp":1760151593695,"version":"build-2065373602"},"reference-count":85,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Complications related to neuromuscular blockade (NMB) could occur during anesthesia induction, maintenance, and emergency. It is recommended that neuromuscular monitoring techniques be utilized perioperatively to avoid adverse outcomes. However, current neuromuscular monitoring methods possess different shortcomings. They are cumbersome to use, susceptible to disturbances, and have limited alternative monitoring sites. Phonomyography (PMG) monitoring based on the acoustic signals yielded by skeletal muscle contraction is emerging as an interesting and innovative method. This technique is characterized by its convenience, stable signal quality, and multimuscle recording ability and shows great potential in the application field. This review summarizes the progression of PMG on perioperative neuromuscular monitoring chronologically and presents the merits, demerits, and challenges of PMG-based equipment, aiming at underscoring the potential of PMG-based apparatuses for neuromuscular monitoring.<\/jats:p>","DOI":"10.3390\/s22072448","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T23:30:23Z","timestamp":1647991823000},"page":"2448","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Phonomyography on Perioperative Neuromuscular Monitoring: An Overview"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5461-4951","authenticated-orcid":false,"given":"Yanjie","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S277","DOI":"10.1038\/sj.bjp.0706404","article-title":"Neuromuscular Block","volume":"147","author":"Bowman","year":"2006","journal-title":"Br. J. Pharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/106002809102500111","article-title":"Clinical Pharmacology of the Neuromuscular Blocking Agents","volume":"25","author":"Larijani","year":"1991","journal-title":"DICP"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jpeds.2017.10.011","article-title":"Obese Children Require Lower Doses of Pantoprazole Than Nonobese Peers to Achieve Equal Systemic Drug Exposures","volume":"193","author":"Shakhnovich","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.auec.2020.02.005","article-title":"Neuromuscular monitoring during modified rapid sequence induction: A comparison of TOF-Cuff\u00ae and TOF-Scan\u00ae","volume":"23","author":"Chau","year":"2020","journal-title":"Australas. Emerg. Care"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zhang, X.-F., Li, D.-Y., Wu, J.-X., Jiang, Q.-L., Zhu, H.-W., and Xu, M.-Y. (2018). Comparison of deep or moderate neuromuscular blockade for thoracoscopic lobectomy: A randomized controlled trial. BMC Anesthesiol., 18.","DOI":"10.1186\/s12871-018-0666-6"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"i53","DOI":"10.1093\/bja\/aex318","article-title":"Reversal of residual neuromuscular block: Complications associated with perioperative management of muscle relaxation","volume":"119","author":"Hunter","year":"2017","journal-title":"Br. J. Anaesth."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"202","DOI":"10.4103\/joacp.JOACP_195_18","article-title":"A multicenter survey on the use of neuromuscular blockade in Greece. Does the real-world clinical practice indicate the necessity of guidelines?","volume":"35","author":"Batistaki","year":"2019","journal-title":"J. Anaesthesiol. Clin. Pharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1111\/anae.15501","article-title":"Recommendations for Standards of Monitoring During Anaesthesia and Recovery 2021: Guideline from the Association of Anaesthetists","volume":"76","author":"Klein","year":"2021","journal-title":"Anaesthesia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/anae.13316","article-title":"Recommendations for standards of monitoring during anaesthesia and recovery 2015: Association of Anaesthetists of Great Britain and Ireland","volume":"71","author":"Checketts","year":"2015","journal-title":"Anaesthesia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/aas.12907","article-title":"Objective Neuromuscular Monitoring of Neuromuscular Blockade in Denmark: An Online-Based Survey of Current Practice","volume":"61","author":"Eskildsen","year":"2017","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/BF03021901","article-title":"Brief review: Neuromuscular monitoring: An update for the clinician","volume":"54","author":"Hemmerling","year":"2007","journal-title":"Can. J. Anaesth."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1213\/ANE.0000000000002387","article-title":"Neuromuscular Monitoring in the Perioperative Period","volume":"126","author":"Murphy","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/anae.13738","article-title":"Conceptual and technical insights into the basis of neuromuscular monitoring","volume":"72","author":"Naguib","year":"2017","journal-title":"Anesthesia"},{"key":"ref_14","first-page":"55","article-title":"Neuromuscular monitoring: An update","volume":"25","author":"Tudorache","year":"2018","journal-title":"Rom. J. Anaesth. Intensiv. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s10877-018-0231-3","article-title":"Mindray 3-directional NMT Module (a new generation \u201cTri-axial\u201d neuromuscular monitor) versus the Relaxometer mechanomyograph and versus the TOF-Watch SX acceleromyograph","volume":"33","author":"Dahaba","year":"2018","journal-title":"Int. J. Clin. Monit. Comput."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.accpm.2016.01.003","article-title":"Comparison of the Tof-Scan\u2122 Acceleromyograph to Tof-Watch Sx\u2122: Influence of Calibration","volume":"35","author":"Colegrave","year":"2016","journal-title":"Anaesth. Crit. Care Pain Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1111\/anae.15009","article-title":"Progress towards a standard of quantitative twitch monitoring","volume":"75","author":"Bowdle","year":"2020","journal-title":"Anesthesia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/BF03021816","article-title":"Comparison of phonomyography, kinemyography and mechanomyography for neuromuscular monitoring","volume":"53","author":"Trager","year":"2006","journal-title":"Can. J. Anaesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"133","DOI":"10.17085\/apm.21014","article-title":"The latest trend in neuromuscular monitoring: Return of the electromyography","volume":"16","author":"Lee","year":"2021","journal-title":"Anesth. Pain Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1111\/j.1399-6576.2007.01352.x","article-title":"Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: The Stockholm revision","volume":"51","author":"Claudius","year":"2007","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1093\/bja\/83.3.405","article-title":"Acoustic monitoring of intraoperative neuromuscular block","volume":"83","author":"Dascalu","year":"1999","journal-title":"Br. J. Anaesth."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1097\/00000542-200009000-00012","article-title":"Temporal Relation between Acoustic and Force Responses at the Adductor Pollicis during Nondepolarizing Neuromuscular Block","volume":"93","author":"Bellemare","year":"2000","journal-title":"Anesthesiology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/BF03016873","article-title":"Duration of control stimulation does not affect onset and offset of neuromuscular blockade at the corrugator supercilii muscle measured with phonomyography or acceleromyography","volume":"49","author":"Hemmerling","year":"2002","journal-title":"Can. J. Anaesth."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/bja\/88.3.389","article-title":"Phonomyography of the corrugator supercilii muscle: Signal characteristics, best recording site and comparison with acceleromyography","volume":"88","author":"Hemmerling","year":"2002","journal-title":"Br. J. Anaesth."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/00000542-200302000-00015","article-title":"Phonomyography as a Novel Method to Determine Neuromuscular Blockade at the Laryngeal Adductor Muscles: Comparison with the Cuff Pressure Method","volume":"98","author":"Hemmerling","year":"2003","journal-title":"Anesthesiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1007\/BF03018768","article-title":"Comparison of phonomyography with balloon pressure mechanomyography to measure contractile force at the corrugator supercilii muscle","volume":"51","author":"Hemmerling","year":"2004","journal-title":"Can. J. Anaesth."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1007\/BF03018451","article-title":"Phonomyographic measurements of neuromuscular blockade are similar to mechanomyography for hand muscles","volume":"51","author":"Hemmerling","year":"2004","journal-title":"Can. J. Anaesth."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1213\/01.ANE.0000096003.64059.97","article-title":"Phonomyography and Mechanomyography Can Be Used Interchangeably to Measure Neuromuscular Block at the Adductor Pollicis Muscle","volume":"99","author":"Hemmerling","year":"2004","journal-title":"Anesth. Analg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1213\/01.ANE.0000112305.87873.61","article-title":"Simultaneous Determination of Neuromuscular Blockade at the Adducting and Abducting Laryngeal Muscles Using Phonomyography","volume":"98","author":"Hemmerling","year":"2004","journal-title":"Anesth. Analg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1093\/bja\/aei183","article-title":"The staircase phenomenon at the corrugator supercilii muscle in comparison with the hand muscles","volume":"95","author":"Deschamps","year":"2005","journal-title":"Br. J. Anaesth."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1213\/01.ANE.0000152189.85483.0E","article-title":"An External Monitoring Site at the Neck Cannot Be Used to Measure Neuromuscular Blockade of the Larynx","volume":"100","author":"Hemmerling","year":"2005","journal-title":"Anesth. Analg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1007\/BF03021772","article-title":"Monitoring neuromuscular blockade at the vastus medialis muscle using phonomyography","volume":"52","author":"Michaud","year":"2005","journal-title":"Can. J. Anaesth."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1213\/01.ANE.0000144067.42615.AD","article-title":"Dominance of the Hand Does Not Change the Phonomyographic Measurement of Neuromuscular Block at the Adductor Pollicis Muscle","volume":"100","author":"Michaud","year":"2005","journal-title":"Anesth. Analg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/BF03021490","article-title":"Total intravenous anesthesia with propofol augments the potency of mivacurium","volume":"55","author":"Hemmerling","year":"2008","journal-title":"Can. J. Anaesth."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Wehbe, M., Mathieu, P.A., and Hemmerling, T.M. (September, January 28). Relaxofon: A neuromuscular blockade monitor for patients under general anesthesia. Proceedings of the 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, San Diego, CA, USA.","DOI":"10.1109\/EMBC.2012.6345893"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.jelekin.2006.04.002","article-title":"A Comparison between Mechanomyographic Condenser Microphone and Accelerometer Measurements During Submaximal Isometric, Concentric and Eccentric Contractions","volume":"17","author":"Madeleine","year":"2007","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jelekin.2004.06.006","article-title":"Experimental muscle pain increases mechanomyographic signal activity during sub-maximal isometric contractions","volume":"15","author":"Madeleine","year":"2005","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1002\/mus.880130403","article-title":"Acoustic and surface EMG diagnosis of pediatric muscle disease","volume":"13","author":"Barry","year":"1990","journal-title":"Muscle Nerve"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.jelekin.2009.09.003","article-title":"Uncovering patterns of forearm muscle activity using multi-channel mechanomyography","volume":"20","author":"Alves","year":"2010","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_40","first-page":"267","article-title":"Acoustic myography as a control signal for an externally powered prosthesis","volume":"67","author":"Barry","year":"1986","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1016\/j.injury.2017.08.051","article-title":"Phonomyography as a non-invasive continuous monitoring technique for muscle ischemia in an experimental model of acute compartment syndrome","volume":"48","author":"Martinez","year":"2017","journal-title":"Injury"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0006-3495(80)85080-6","article-title":"Low frequency sounds from sustained contraction of human skeletal muscle","volume":"30","author":"Oster","year":"1980","journal-title":"Biophys. J."},{"key":"ref_43","first-page":"532","article-title":"Phonomyography--acoustic myography using condenser microphones: A promising new method of monitoring neuromuscular transmission","volume":"30","author":"Hemmerling","year":"2002","journal-title":"Anaesth. Intensiv. Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1113\/jphysiol.1948.sp004290","article-title":"The sounds from single motor units in a contracting muscle","volume":"107","author":"Gordon","year":"1948","journal-title":"J. Physiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/mus.880080303","article-title":"Acoustic myography: A noninvasive monitor of motor unit fatigue","volume":"8","author":"Barry","year":"1985","journal-title":"Muscle Nerve"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1152\/jappl.1991.71.4.1422","article-title":"Acoustic myography for investigating human skeletal muscle fatigue","volume":"71","author":"Stokes","year":"1991","journal-title":"J. Appl. Physiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/0022-510X(92)90093-Z","article-title":"Acoustic myography of the human quadriceps muscle during intermittent fatiguing activity","volume":"109","author":"Dalton","year":"1992","journal-title":"J. Neurol. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/S0021-9290(99)00132-3","article-title":"Acoustic myography during voluntary isometric contraction reveals non-propagative lateral vibration","volume":"32","author":"Ouamer","year":"1999","journal-title":"J. Biomech."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00868071","article-title":"Acoustic myography reflects force changes during dynamic concentric and eccentric contractions of the human biceps brachii muscle","volume":"63","author":"Dalton","year":"1991","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1152\/jappl.1991.70.1.87","article-title":"Acoustic myography as an indicator of force during sustained contractions of a small hand muscle","volume":"70","author":"Goldenberg","year":"1991","journal-title":"J. Appl. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/0022-510X(91)90041-5","article-title":"Acoustic myographic activity increases linearly up to maximal voluntary isometric force in the human quadriceps muscle","volume":"101","author":"Stokes","year":"1991","journal-title":"J. Neurol. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/BF00626281","article-title":"Electro and acoustic myography for noninvasive assessment of lumbar paraspinal muscle function","volume":"64","author":"Lee","year":"1992","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1164\/ajrccm.155.3.9117004","article-title":"Diaphragmatic fatigue investigated by phonomyography","volume":"155","author":"Petitjean","year":"1997","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2567","DOI":"10.1152\/jappl.1992.73.6.2567","article-title":"Evaluation of human dynamic contraction by phonomyography","volume":"73","author":"Petitjean","year":"1992","journal-title":"J. Appl. Physiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0006-3495(83)84403-8","article-title":"Muscle contraction generates discrete sound bursts","volume":"41","author":"Brozovich","year":"1983","journal-title":"Biophys. J."},{"key":"ref_56","first-page":"573","article-title":"Muscle sounds from evoked twitches in the hand","volume":"72","author":"Barry","year":"1991","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1055\/s-2007-1021237","article-title":"Can Evoked Phonomyography Be Used to Recognize Fast and Slow Muscle in Man?","volume":"13","author":"Marchetti","year":"1992","journal-title":"Int. J. Sports Med."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Orizio, C., and Gobbo, M. (2006). Mechanomyography. Wiley Encyclopedia of Biomedical Engineering, Wiley.","DOI":"10.1002\/9780471740360.ebs0731"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/ALN.0000000000004044","article-title":"Quantitative Neuromuscular Monitoring and Postoperative Outcomes: A Narrative Review","volume":"136","author":"Murphy","year":"2021","journal-title":"Anesthesiology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"22940","DOI":"10.3390\/s141222940","article-title":"Mechanomyographic Parameter Extraction Methods: An Appraisal for Clinical Applications","volume":"14","author":"Ibitoye","year":"2014","journal-title":"Sensors"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1002\/mus.880171011","article-title":"Phonomyogram of the diaphragm during unilateral and bilateral phrenic nerve stimulation and changes with fatigue","volume":"17","author":"Petitjean","year":"1994","journal-title":"Muscle Nerve"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1007\/BF00357671","article-title":"Time and frequency domain analysis of electromyogram and sound myogram in the elderly","volume":"73","author":"Esposito","year":"1996","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1152\/jappl.1993.74.2.532","article-title":"Mapping of electrical muscle stimulation using MRI","volume":"74","author":"Adams","year":"1993","journal-title":"J. Appl. Physiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1002\/mus.880120207","article-title":"Recording sound from human skeletal muscle: Technical and physiological aspects","volume":"12","author":"Bolton","year":"1989","journal-title":"Muscle Nerve"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1055\/s-2005-861037","article-title":"Effect of Rocuronium on the Diaphragm, Musculus Adductor Pollicis and Orbicularis Oculi in Two Groups of Different Age","volume":"40","author":"Moerer","year":"2005","journal-title":"Anasthesiol. Intensivmed. Notfallmed. Schmerzther."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/j.bja.2018.11.011","article-title":"Comparison of the TOF-Cuff\u00ae monitor with electromyography and acceleromyography during recovery from neuromuscular block","volume":"122","author":"Krijtenburg","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s00540-018-2587-4","article-title":"Efficiency of the TOF-Cuff\u2122 for the evaluation of rocuronium-induced neuromuscular block and its reversal with sugammadex: A comparative study vs. acceleromyography","volume":"33","author":"Kameyama","year":"2018","journal-title":"J. Anesth."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/BF03019373","article-title":"Neuromuscular blockade at the larynx, the diaphragm and the corrugator supercilii muscle: A review","volume":"50","author":"Hemmerling","year":"2003","journal-title":"Can. J. Anaesth."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/2110-5820-4-3","article-title":"Pharmacodynamics of cisatracurium in the intensive care unit: An observational study","volume":"4","author":"Dieye","year":"2014","journal-title":"Ann. Intensive Care"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1097\/00001503-200112000-00010","article-title":"Neuromuscular Monitoring","volume":"14","year":"2001","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_71","first-page":"201","article-title":"Muscle sound: Bases for the introduction of a mechanomyographic signal in muscle studies","volume":"21","author":"Orizio","year":"1993","journal-title":"Crit. Rev. Biomed. Eng."},{"key":"ref_72","first-page":"239","article-title":"Variability in muscle fibre areas in whole human quadriceps muscle: Effects of increasing age","volume":"174","author":"Lexell","year":"1991","journal-title":"J. Anat."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s10877-013-9451-8","article-title":"A technical description of a novel pharmacological anesthesia robot","volume":"28","author":"Wehbe","year":"2014","journal-title":"Int. J. Clin. Monit. Comput."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e00029","DOI":"10.1002\/phy2.29","article-title":"Portable acoustic myography\u2014A realistic noninvasive method for assessment of muscle activity and coordination in human subjects in most home and sports settings","volume":"1","author":"Harrison","year":"2013","journal-title":"Physiol. Rep."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s10974-019-09516-y","article-title":"An acoustic myography functional assessment of cerebral palsy subjects compared to healthy controls during physical exercise","volume":"40","author":"Pingel","year":"2019","journal-title":"J. Muscle Res. Cell Motil."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"80","DOI":"10.5455\/OVJ.2013.v3.i2.p80","article-title":"Non-invasive assessment of equine muscular function: A case study","volume":"3","author":"Riis","year":"2013","journal-title":"Open Vet. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/cpf.12417","article-title":"A more precise, repeatable and diagnostic alternative to surface electromyography\u2014An appraisal of the clinical utility of acoustic myography","volume":"38","author":"Harrison","year":"2018","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.clinbiomech.2014.04.003","article-title":"Mechanomyography and muscle function assessment: A review of current state and prospects","volume":"29","author":"Ibitoye","year":"2014","journal-title":"Clin. Biomech."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1109\/TBME.2005.851531","article-title":"A Mathematical Model for Source Separation of MMG Signals Recorded With a Coupled Microphone-Accelerometer Sensor Pair","volume":"52","author":"Silva","year":"2005","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"100918","DOI":"10.1016\/j.accpm.2021.100918","article-title":"Pro: Deep Neuromuscular Blockade Should be Maintained During Laparoscopic Surgery","volume":"40","author":"Murphy","year":"2021","journal-title":"Anaesth. Crit. Care Pain Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1136\/neurintsurg-2020-015947","article-title":"Deep neuromuscular block improves angiographic image quality during endovascular coiling of unruptured cerebral aneurysm: A randomized clinical trial","volume":"12","author":"Kim","year":"2020","journal-title":"J. Neurointerv. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1093\/bja\/aev368","article-title":"Deep neuromuscular block improves the surgical conditions for laryngeal microsurgery","volume":"115","author":"Kim","year":"2015","journal-title":"Br. J. Anaesth."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1016\/j.medengphy.2011.12.007","article-title":"Design and evaluation of a novel microphone-based mechanomyography sensor with cylindrical and conical acoustic chambers","volume":"34","author":"Posatskiy","year":"2012","journal-title":"Med. Eng. Phys."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jelekin.2011.09.004","article-title":"The effects of motion artifact on mechanomyography: A comparative study of microphones and accelerometers","volume":"22","author":"Posatskiy","year":"2012","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"14568","DOI":"10.1038\/s41598-021-94062-2","article-title":"Comparison between the trapezius and adductor pollicis muscles as an acceleromyography monitoring site for moderate neuromuscular blockade during lumbar surgery","volume":"11","author":"Oh","year":"2021","journal-title":"Sci. Rep."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/7\/2448\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:41:13Z","timestamp":1760136073000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/7\/2448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,22]]},"references-count":85,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["s22072448"],"URL":"https:\/\/doi.org\/10.3390\/s22072448","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2022,3,22]]}}}