: A Comparison of Neuromuscular Transmission in the Muscles During General Anesthesia
Condition: Neuromuscular Blockade
Study type: Observational

Summary: 
      The investigators want to compare new muscle relaxation monitoring, TOF-Cuff and TOF-Scan,
      during general anesthesia. Standard monitoring is using thumb, however it can't be use on
      every patient. Alternative can be eyebrow muscle or foot muscle.

      There is only few old study that compares this muscle and used mivacurium. The study aims to
      compare TOF-Cuff and TOF-Scan with different sensor and use mivacurium.
    

Detailed description: 
      In our research in addition to the standard intraoperative monitoring, which includes the
      assessment of ECG and saturation, the investigators would like to estimate muscle relaxation
      by using two different methods: a TOF-Cuff which additionally allows to measure inoperative
      blood pressure and TOF-Scan with different sensor. Our aim is to compare two different
      methods of muscle relaxation monitoring in patients who will administer muscle relaxant -
      mivacurium. After receiving painkillers and hypnotics, when the patient is falling asleep,
      the standard dose of mivacurium 0.2 mg / kg body weight will be administered. Then, painless
      simultaneous stimulation with TOF-Cuff and TOF-Scan devices will begin. Until intubation,
      measurements will be made in every 30 seconds and then every 5 minutes until extubation.
      Extubation will take place according to the guidelines when the TOF-Cuff measurement on the
      arm is greater than 0.9 - this is the value at which the patient is considered ready to start
      breathing on his own. The following will be documented: the initiation of drug
      administration, intubation, possible repeated doses of mivacurium 2 mg, antagonization,
      extubation, possible side effects (e.g., transient cardiac disturbances, reddening of the
      skin, lowering blood pressure, bronchospasm, erythema, urticaria) and technical problems.
    

Intervention name(s): TOF Cuff on arm; TOF Cuff on lower leg; TOF Scan on toe; TOF Scan on adductor pollicis; TOF Scan on corrugator supercilii
Intervention type(s): Device; Device; Device; Device; Device
Intervention description(s): The TOF Cuff will be installed on one arm in opposite of TOF Scan. After intubation dose of mivacurium continuous monitoring of neuromuscular block started until complete recovery of neuromuscular block.; The TOF Cuff will be installed on one lower leg. After intubation dose of mivacurium continuous monitoring of neuromuscular block started until complete recovery of neuromuscular block.; The TOF Scan will be installed on hallux . After intubation dose of mivacurium continuous monitoring of neuromuscular block started until complete recovery of neuromuscular block.; The TOF Scan will be installed on Thumb. After intubation dose of mivacurium continuous monitoring of neuromuscular block started until complete recovery of neuromuscular block.; The TOF Scan will be installed on corrugator supercilii. After intubation dose of mivacurium continuous monitoring of neuromuscular block started until complete recovery of neuromuscular block.
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        In the study will take patients qualified to the elective surgery
      
Keywords: TOF Cuff; TOF Scan; Neuromuscular transmission; corrugator supercilii; Mivacurium; adductor pollicis