The Quantitative Train of Four vs Subjective or Qualitative TOF study attached shows Quantitative TOF monitoring promoting a positive clinical practice change. Quantitative TOF monitoring may be the greatest tool to use to safely monitor paralytic and reverse anesthesia patients safely.
The study tables show when using a traditional Peripheral Nerve Stimulator or PNS to monitor Neuro Muscular Blocking Agents or NMBA subjectively that Neostigmine and Sugammadex were often given to patients that did not need any reversal as shown in the top third of first table. The middle third of the first table shows patients were given sugammadex when they could have been administered Neostigmine as patient’s TOF ratio was over 40%. The lower third of the first table (TOF Ratio < 40%) shows several instances where Neostigmine was given, risking incomplete reversal. The second table shows when using Quantitative TOF monitoring the anesthesia providers used Sugammadex and Neostigmine and no reversal at the appropriate times resulting in safer use of medications and better overall safer patient care. The second table also shows a high percentage of patients did not need or get reversal whereas ALL patients were given some reversal shown in table one even when not needed with subjective monitoring.
Quantitative Train of Four monitoring aids anesthesia providers in safely managing paralytics and reversal drugs during general anesthesia.