What is EMG Monitoring? How Tetragraph Can Enhance Clinical Practice

Electromyography (EMG) is considered the new gold standard for neuromuscular blockade (NMB) monitoring. It measures the action potential at the neuromuscular junction, whereas traditional technologies such as acceleromyography (AMG) measure muscle movement instead. Tetragraph is an example of an EMG-based NMB monitor. EMG offers significant advantages over AMG:

EMG is significantly more precise than AMG

AMG monitors tend to overshoot and therefore overestimate the level of recovery, showing great variability in their results. EMG does not exhibit the same level of variability, instead delivering accurate, true readings. Explore in more detail here.

EMG delivers reliable readings when movement is impeded

Because they measure movement, AMG monitors cannot provide accurate readings in procedures where free movement is impeded (for example, robotic-assisted surgery or laparoscopic cases requiring the arms to be tucked). EMG does not measure movement and is therefore not affected by this limitation.

EMG monitors do not require calibration: they deliver results even if connected after NMB has been administered

AMG monitors should be connected to the patient before a paralytic is administered, as they need to be calibrated to provide a baseline value against which subsequent results are normalised. Baseline readings can often exceed a TOFR of 100%, a so-called “reverse fade phenomenon”. EMG is not subject to this reverse fade. The same calibration or result normalisation is therefore not required, meaning you can still obtain accurate readings in scenarios where NMB has already been administered, such as rapid sequence inductions.

To learn more about the differences between AMG and EMG, register for this free on-demand webinar.