---
title: Comparing Train-of-Four Recovery in the Adductor Pollicis Versus the Adductor Digiti Minimi in Elective Surgery Patients
nct_id: NCT06467448
overall_status: COMPLETED
sponsor: University of North Carolina, Chapel Hill
study_type: OBSERVATIONAL
primary_condition: Anesthesia
countries: United States
canonical_url: "https://parkinsonspathways.com/agent/trials/NCT06467448.md"
clinicaltrials_gov: "https://clinicaltrials.gov/study/NCT06467448"
ct_last_update_post_date: 2026-01-13
last_seen_at: "2026-05-12T06:44:26.685Z"
source: ClinicalTrials.gov (mirrored, no enrichment)
---
# Comparing Train-of-Four Recovery in the Adductor Pollicis Versus the Adductor Digiti Minimi in Elective Surgery Patients

**Official Title:** Comparing Train-of-Four Recovery in the Adductor Pollicis Versus the Adductor Digiti Minimi in Elective Surgery Patients Using EMG

**NCT ID:** [NCT06467448](https://clinicaltrials.gov/study/NCT06467448)

## Key Facts

- **Status:** COMPLETED
- **Study Type:** OBSERVATIONAL
- **Target Enrollment:** 57
- **Lead Sponsor:** University of North Carolina, Chapel Hill
- **Conditions:** Anesthesia, Neuromuscular Blockade
- **Start Date:** 2024-03-18
- **Completion Date:** 2025-06-01
- **CT.gov Last Update:** 2026-01-13

## Brief Summary

The train-of-four (TOF) ratio is a quantitative measure used in anesthesia to assess the degree of neuromuscular blockade induced by neuromuscular blocking agents during surgical procedures. Current American Society of Anesthesiologists guidelines recommend monitoring the TOF ratio to guide the administration and reversal of NMBAs, with a target ratio of 0.9 or higher at adductor pollicis muscle indicating adequate reversal and restoration of neuromuscular function.

This proposed study aims to observe and compare the TOF ratio between two different muscles of the hand: adductor pollicis and adductor digiti minim using anesthesia monitors on both of their arms during recovery of neuromuscular function. Surgery and anesthesia will occur per standard of care.

## Detailed Description

The study population will enroll adult patients (\>18) who will receive non-depolarizing neuromuscular blocking drugs as part of a routine general anesthetic and who will have monitoring of their recovery from neuromuscular block performed using the Tetragraph (Senzime Sweden). Patients with upper limb weakness, neurological deficits, and inability to use the other arm to record the second EMG recording will be excluded.

Procedures (methods):

Adult patients undergoing general anesthesia with the use of muscle relaxants will have anesthesia monitors on both of their arms. On one arm, the study sticky pad will be placed on the forearm and over the base of the little finger. On the other arm, the standard monitor is placed on the forearm and over the base of the thumb.

To identify pre-operative patients, an EPIC report will be utilized to screen for eligible participants. Patients will be contacted via phone by a research team member the day before their procedure and enrolled. Informed consent will be formally obtained on the day of the procedure.

## Eligibility

- **Minimum age:** 18 Years
- **Sex:** ALL
- **Healthy Volunteers:** No

```
Inclusion Criteria:

* Surgery and general anesthesia with administration of non depolarizing neuromuscular blocking drug

Exclusion Criteria:

* neuromuscular disease or weakness of one of upper limbs.
* Inability to use one of subjects arms to record neuromuscular monitor.
* Contraindication to administration or allergy to non depolarizing neuromuscular blocking drug.
```

## Arms

- **Adductor Pollicis EMG** — The Train of Four Ratio will be recorded at 90% as a time and as a reference point
- **Adductor Digiti Minimi** — The Train of Four Ratio will be recorded when the adductor pollicis ratio reads 90%

## Interventions

- **EMG Assessement of Recovery of Neuromuscular Function** (DEVICE) — EMG Train of Four Assessment of Recovery of Neuromuscular Function

## Primary Outcomes

- **Difference in Measured Recovery of Train of Four at Adductor Pollicis and Adductor Digiti Minimi** _(time frame: All assessments are intraoperative and complete in one day)_ — The train of four ratio at the digiti minimi will be recorded when the adductor pollicis ratio reads 90 percent

## Locations (1)

- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

## Recent Field Changes (last 30 days)

- `status.overallStatus` — added _(2026-05-12)_
- `status.primaryCompletionDate` — added _(2026-05-12)_
- `status.completionDate` — added _(2026-05-12)_
- `status.lastUpdatePostDate` — added _(2026-05-12)_
- `design.enrollmentCount` — added _(2026-05-12)_
- `eligibility.criteria` — added _(2026-05-12)_
- `eligibility.minAge` — added _(2026-05-12)_
- `eligibility.sex` — added _(2026-05-12)_
- `outcomes.primary` — added _(2026-05-12)_
- `armsInterventions.arms` — added _(2026-05-12)_
- `armsInterventions.interventions` — added _(2026-05-12)_
- `sponsor.lead` — added _(2026-05-12)_
- `results.hasResults` — added _(2026-05-12)_
- `locations.university of north carolina at chapel hill|chapel hill|north carolina|united states` — added _(2026-05-12)_

---

*Canonical: https://parkinsonspathways.com/agent/trials/NCT06467448.md*  
*Source data (authoritative): https://clinicaltrials.gov/study/NCT06467448*  
*This page is a raw mirror with no AI summary, no editorial enrichment, and no Parkinson's-specific filtering.*