Does Electromyography Improve Precision and Reliability of Neuromuscular Monitoring in Paediatric Patients

The ETCETERA trial is a randomized clinical agreement study which will prospectively enrol sixty-four children below five years of age scheduled for elective, non-cardiac surgery requiring general anaesthesia and neuromuscular blockade for optimisation of surgical conditions. The children's neuromuscular function is measured on one hand with EMG and on the other hand with KMG in a randomised fashion. Additionally, randomisation will be stratified upon age groups: 1) neonates: birth to \<28 days, 2) infants 28 days to ≤3 months, 3) toddlers: \>3 months to ≤2 years, 4) children \>2 years to \<5 years. Based on the high failure rate of currently available neuromuscular monitoring devices in infants and neonates, in this randomised agreement study we will primarily compare precision and reliability of EMG and KMG-measured Train-of-Four (TOF) values during spontaneous recovery from a rocuronium-induced neuromuscular blockade in neonates, infants, toddlers, and children \<5 years using the age-appropriate paediatric sensors.