Comparison of train-of-four count by anesthesia providers versus TOF-Watch® SX: a prospective cohort study.

Purpose: Qualitative monitoring of neuromuscular blockade using the train-of-four (TOF) count is widely used to determine the timing and dose of reversal agents for neuromuscular blockade. We compared TOF count measured manually by anesthesia providers with that determined by TOF-Watch® SX.

Methods: This prospective observational cohort study included patients who were American Society of Anesthesiologists physical status III or less and undergoing elective surgery.