Koo Chang-Hoon
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Anesth Pain Med (Seoul). 2025 Jul;20(3):222-229. doi: 10.17085/apm.25267. Epub 2025 Jul 31.
Electromyography (EMG)-based neuromuscular monitoring has emerged as a pivotal advancement in anesthesia, offering enhanced precision and reliability in assessing neuromuscular blockade. This review describes the physiological foundations of EMG, the methodologies for quantifying compound muscle action potential, and the comparative utility of EMG over traditional acceleromyography. Clinical applications across various muscle sites-specifically the adductor pollicis, first dorsal interosseous, and abductor digiti minimi-are explored, emphasizing inter-muscle variability and its implications for dosing of reversal agents. EMG-based monitoring is associated with reduced calibration time, improved stability against signal drift, and superior prevention of residual neuromuscular blockade. However, EMG monitoring presents unique challenges, including signal artifacts and device-specific variations in response thresholds. Recent comparative studies have demonstrated the importance of understanding device-specific characteristics to optimize clinical interpretations. Collectively, this evidence supports the use of EMG as a standard modality for perioperative neuromuscular management. Its accurate and reproducible signals, combined with broad clinical compatibility, present a compelling case for widespread adoption in routine anesthetic practice.
基于肌电图（EMG）的神经肌肉监测已成为麻醉领域的一项关键进展，在评估神经肌肉阻滞方面提供了更高的精度和可靠性。本综述描述了肌电图的生理基础、量化复合肌肉动作电位的方法，以及肌电图相对于传统加速度肌电图的比较效用。探讨了在各个肌肉部位（特别是拇收肌、第一背侧骨间肌和小指展肌）的临床应用，强调了肌肉间的变异性及其对逆转剂给药的影响。基于肌电图的监测具有校准时间缩短、抗信号漂移稳定性提高以及预防残余神经肌肉阻滞效果更佳的特点。然而，肌电图监测也带来了独特的挑战，包括信号伪迹和设备响应阈值的特定差异。最近的比较研究表明，了解设备特定特性对于优化临床解释至关重要。总体而言，这些证据支持将肌电图用作围手术期神经肌肉管理的标准模式。其准确且可重复的信号，加上广泛的临床兼容性，为在常规麻醉实践中广泛采用提供了有力依据。
