Dominance of the Hand Does Not Change the Phonomyographic Measurement of Neuromuscular Block at the Adductor Pollicis Muscle
Bibliographic record
Abstract
Phonomyography (PMG) is a novel method to determine neuromuscular blockade (NMB) with high sensitivity and applicability at all muscles. The adductor pollicis muscle has long been used in research and clinical practice as reference for neuromuscular monitoring. The goal of our study was to compare PMG signals (train-of-four [TOF] ratios and T(1)/T(0) values) from both hands of the same patient to investigate the influence of hand dominance on neuromuscular monitoring. In 14 patients, PMG was recorded via small piezoelectric microphones taped over the thenar mass of both hands. After induction of anesthesia, both ulnar nerves were stimulated supramaximally using TOF stimulation every 12 s. Mivacurium 0.2 mg/kg was administered within 5 s. Onset, maximum effect, and offset of NMB were compared between both adductor pollicis muscles. Twelve patients were right-handed and two patients were left-handed. No statistical difference was found between the signals from the dominant or nondominant hand. Correlation was very good (r = 0.95). Agreement was excellent with a bias of -0.57% and limits of agreement of -17.9% to 16.7% (dominant - nondominant hand). This study shows minimal bias, good correlation and no statistical difference when NMB is monitored at both the dominant and nondominant adductor pollicis muscles. Both hands could be used interchangeably to assess NMB at the adductor pollicis muscle.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".