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Dong Y, Guo W, Yang Y, Li Q. The Effect of Phonomyography Prototype for Intraoperative Neuromuscular Monitoring: A Preliminary Study. Bioengineering (Basel) 2024; 11:486. [PMID: 38790354 PMCID: PMC11117765 DOI: 10.3390/bioengineering11050486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/29/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Quantitative neuromuscular monitoring, as extolled by clinical guidelines, is advocated to circumvent the complications associated with neuromuscular blockers (NMBs), such as residual neuromuscular block (rNMB). Nonetheless, the worldwide utilization of such methods remains undesirable. Phonomyography (PMG) boasts the advantages of convenience, stability, and multi-muscle recording which may be a promising monitoring method. The purpose of this preliminary study is conducting a feasibility analysis and an effectiveness evaluation of a PMG prototype under general anesthesia. A prospective observational preliminary study was conducted. Twenty-five adults who had undergone none-cardiac elective surgery were enrolled. The PMG prototype and TOF-Watch SX simultaneously recorded the pharmacodynamic properties of single bolus rocuronium at the ipsilateral adductor pollicis for each patient. For the primary outcome, the time duration to 0.9 TOF ratio of the two devices reached no statistical significance (p > 0.05). For secondary outcomes, the multi-temporal neuromuscular-monitoring measurements between the two devices also reached no statistical significance (p > 0.05). What is more, both the Spearman's and Pearson's correlation tests revealed a strong correlation across all monitoring periods between the PMG prototype and TOF-Watch SX. Additionally, Bland-Altman plots demonstrated a good agreement between the two devices. Thus, the PMG prototype was a feasible, secure, and effective neuromuscular-monitoring technique during general anesthesia and was interchangeable with TOF-Watch SX.
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Affiliation(s)
- Yanjie Dong
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China;
| | - Weichao Guo
- Meta Robotics Institute, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Yi Yang
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, Chengdu 610072, China;
| | - Qian Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China;
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Dong Q, Long Y, Jin L, Hou G, Li G, Wang T, Jia H, Yin Y, Guo J, Ma H, Xu S, Zhang Y, Hou Z. Establishment and pathophysiological evaluation of a novel model of acute compartment syndrome in rats. BMC Musculoskelet Disord 2024; 25:70. [PMID: 38233913 PMCID: PMC10792863 DOI: 10.1186/s12891-024-07187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Researches have used intra-compartmental infusion and ballon tourniquest to create high intra-compartmental pressure in animal models of Acute Compartment Syndrome (ACS). However, due to the large differences in the modeling methods and the evaluation criteria of ACS, further researches of its pathophysiology and pathogenesis are hindered. Currently, there is no ideal animal model for ACS and this study aimed to establish a reproducible, clinically relevant animal model. METHODS Blunt trauma and fracture were caused by the free falling of weights (0.5 kg, 1 kg, 2 kg) from a height of 40 cm onto the lower legs of rats, and the application of pressures of 100 mmHg, 200 mmHg, 300 mmHg and 400 mmHg to the lower limbs of rats using a modified pressurizing device for 6 h. The intra-compartmental pressure (ICP) and the pressure change (ΔP) of rats with single and combined injury were continuously recorded, and the pathophysiology of the rats was assessed based on serum biochemistry, histological and hemodynamic changes. RESULTS The ΔP caused by single injury method of different weights falling onto the lower leg did not meet the diagnosis criteria for ACS (< 30 mmHg). On the other hand, a combined injury method of a falling weight of 1.0 kg and the use of a pressurizing device with pressure of 300 mmHg or 400 mmHg for 6 h resulted in the desired ACS diagnosis criteria with a ΔP value of less than 30 mmHg. The serum analytes, histological damage score, and fibrosis level of the combined injury group were significantly increased compared with control group, while the blood flow was significantly decreased compared with control group. CONCLUSION We successfully established a new preclinical ACS-like rat model, by the compression of the lower leg of rats with 300 mmHg pressure for 6 h and blunt trauma by 1.0 kg weight falling.
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Affiliation(s)
- Qi Dong
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yubin Long
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Orthopaedics Surgery, Baoding No.1 Central Hospital, Baoding, China
| | - Lin Jin
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | | | - Guoqiang Li
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tao Wang
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huiyang Jia
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yingchao Yin
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Junfei Guo
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Huijie Ma
- Hebei Medical University, Shijiazhuang, China
| | - Sujuan Xu
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Nephrology, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yingze Zhang
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhiyong Hou
- Department of Orthopaedics Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
- Orthopaedic Research Institute of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, China.
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Dong Y, Li Q. Phonomyography on Perioperative Neuromuscular Monitoring: An Overview. SENSORS 2022; 22:s22072448. [PMID: 35408063 PMCID: PMC9003319 DOI: 10.3390/s22072448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/15/2022] [Accepted: 03/20/2022] [Indexed: 02/05/2023]
Abstract
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.
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Affiliation(s)
| | - Qian Li
- Correspondence: ; Tel.: +86-18980601635
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Animal models in compartment syndrome: a review of existing literature. OTA Int 2022; 5:e163. [PMID: 35282390 PMCID: PMC8900462 DOI: 10.1097/oi9.0000000000000163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
Objective: Extremity compartment syndrome (ECS) is a morbid condition resulting in permanent myoneural damage. Currently, the diagnosis of compartment syndrome relies on clinical symptoms and/or intracompartment pressure measurements, both of which are poor predictors of ECS. Animal models have been used to better define cellular mechanisms, diagnosis, and treatment of ECS. However, no standardized model exists. The purpose of this study was to identify existing animal research on extremity compartment syndrome to summarize the current state of the literature and to identify weaknesses that could be improved with additional research. Methods: A MEDLINE database search and reverse inclusion protocol were utilized. We included all animal models of ECS. Results: Forty-one studies were included. Dogs were the most commonly used model species, followed by pigs and rats. Most studies sought to better define the pathophysiology of compartment syndrome. Other studies evaluated experimental diagnostic modalities or potential treatments. The most common compartment syndrome model was intracompartment infusion, followed by tourniquet and intracompartment balloon models. Few models incorporated additional soft tissue or osseous injury. Only 65.9% of the reviewed studies confirmed that their model created myoneural injury similar to extremity compartment syndrome. Conclusions: Study purpose, methodology, and outcome measures varied widely across included studies. A standardized definition for animal compartment syndrome would direct more consistent research in this field. Few animal models have investigated the pathophysiologic relationship between traumatic injury and the development of compartment syndrome. A validated, clinically relevant animal model of extremity compartment syndrome would spur improvement in diagnosis and therapeutic interventions.
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