An interventional study of TetraGraph in Surgery and Neuromuscular Blockade, sponsored by Nationwide Children's Hospital. Enrolling by invitation at 1 site in United States. Open to participants aged 1 Month and older. Per ClinicalTrials.gov, last updated 2026-09-09.
Sponsored by Nationwide Children's Hospital · Not applicable, Interventional, and Diagnostic
In most clinical instances, direct laryngoscopy and endotracheal intubation is performed after a set time (generally 60 seconds) following the administration of a neuromuscular (NM) blocking agent, rocuronium. Although the average onset time is 60 seconds, clinical studies show a standard deviation around the mean onset time of 10-20 seconds, meaning that a significant number of patients do not achieve complete NM blockade by 60 seconds. Given the above noted variability, complete NM blockade may not be achieved in 60 seconds in a significant percentage of patients, resulting in more problematic direct laryngoscopy and endotracheal intubation. Various studies have shown a higher incidence of perioperative respiratory events and postoperative concerns (sore throat, vocal cord injury) when NM blockade is not complete prior to endotracheal intubation.
This study aims to use the TetraGraph monitor to clearly identify onset times of rocuronium. Additionally, whenever feasible based on the clinical needs of the case, recovery times after the single dose of rocuronium will be recorded.
Exclusion Criteria:
Patients receiving a neuromuscular blockade with rocuronium 0.6 mg/kg.
Device: TetraGraph
A monitor that provides an electrical stimulation of the peripheral nerve and directly measures the amplitude of the evoked response of the muscles, thereby providing a quantitative and automatic measurement of muscle response to a stimulus using electromyography (EMG).
Onset time
Amount of time from administration of rocuronium to the monitor reading 0 twitches.
Time frame: Baseline
Recovery time
Amount of time from administration of reversal medication (sugammadex or neostigmine) to monitor reading 4 twitches.
Time frame: At the completion of surgery
Plan to share: No
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Nationwide Children's Hospital