الفهرس 
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Abstract
•This study was performed to compare kinemyography versus electromyography neuromuscular monitoring in pediatric patients receiving cisatracurium or rocuronium during general anesthesia.
• 48 pediatric patients of both sexes aged 2-5 years, with a maximum weight 20 kg, undergoing elective surgery under general anesthesia in Suez Canal University Hospital in the routine surgical lists, were included in the study.
• Monitoring equipments (Datex-Ohmeda A/S 5™) was attached to the patient including 3 leads ECG, automatic non-invasive blood pressure, pulse oximetry; anesthetic gas monitoring and temperature probe was attached to the patient.
The electromyogram was attached to one hand, while, kinemyography was attached to the other hand for simultaneous monitoring.
Induction of anesthesia with fentanyl 2µg/kg and propofol 2 mg/kg followed by endotracheal intubation.
Anesthesia was maintained by end-tidal isoflurane 1.2 %.
Ventilation was kept by 50% oxygen in air and was adjusted to maintain end-tidal CO2 in the range of 35–40 mm Hg.
• After a stable baseline period of at least 3 minutes, the 48 patients were randomly allocated into one of two groups, cisatracurium group and rocuronium group using closed envelope method.
Group 1 (cisatracurium group): (24patients) received 0.1 mg/kg cisatracurium twice the 95% effective dose (2×ED95)
Group 2 (rocuronium group): (24 patients) received 0.6 mg/kg rocuronium (2×ED95)
The following parameters were collected and compared:
1. Lag time: time from start of muscle relaxant administration until the first measurable block TOF ratio 90%.
2. Onset time: time from start of muscle relaxant administration until maximal neuromuscular block.
Assessing the recovery period by:
3. TOF 0.25 = time to reach a TOF ratio of 25%.
4. TOF 0.50 = time to reach a TOF ratio of 50%.
5. TOF 0.75 = time to reach a TOF ratio of 75%.
6. TOF 0.90 = time to reach a TOF ratio of 90%.
• No top-up doses of muscle relaxants were given.
The results of the study were that:
• There was no statistical difference between study groups as regard the demographic data of the patients.
• There was no statistical difference between the lag time using EMG or KMG in both groups.
• No statistical differences were found between the onset time using either KMG or EMG in both groups.
• No statistical differences were detected between TOF 0.25 ratio using either KMG or EMG in both groups.
• No statistical differences were noticed between TOF ratio 0.5 using either KMG or EMG in both groups.
• No statistical differences were found between TOF ratio 0.75 using either KMG or EMG in both groups.
• No statistical differences were detected between TOF ratio 0.9 using either KMG or EMG in both groups.
• In addition, there is excellent degree of agreement between EMG and KMG in measuring TOF ratio during both induction and recovery of muscle relaxants.
Conclusions: Kinemyography shows an excellent degree of agreement with electromyography for determination of onset and recovery of NMB in children. Rocuronium 0.6mg/kg has a faster onset and shorter duration of action than cisatracurium 0.1mg/kg in children.