Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2015
Effects of partial neuromuscular blockade on lateral spread response monitoring during microvascular decompression surgery.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chung Yang Hoon, Kim Won Ho, Chung Ik Soo, Park Kwan, Lim Seong Hyuk, Seo Dae Won, Lee Jeong Jin, Yang Song-I
Аннотация
OBJECTIVE: We evaluated the effect of partial neuromuscular blockade (NMB) and no NMB on successful intraoperative monitoring of the lateral spread response (LSR) during microvascular decompression (MVD) surgery.
METHODS: Patients were randomly allocated into one of three groups: the TOF group, the NMB was targeted to maintain two counts of train-of-four (TOF); the T1 group, maintain the T1/Tc (T1: amplitude of first twitch, Tc: amplitude of baseline twitch) ratio at 50%; and the N group, no relaxants after tracheal intubation. Successful LSR monitoring was defined as effective baseline establishment and maintenance of the LSR until dural opening.
RESULTS: The success rate of LSR monitoring was significantly lower in the TOF group. But, there was no significant difference between T1 and N. The detection rate of spontaneous free-run electromyography (EMG) activity was significantly higher in the N group compared with the TOF and T1 groups.
CONCLUSIONS: Partial NMB with a target of T1/Tc ratio at 50% allows good recording of LSR with same outcome as surgery without NMB, and reduced spontaneous EMG activity.
SIGNIFICANCE: We suggested the availability of partial NMB for intraoperative LSR monitoring.
METHODS: Patients were randomly allocated into one of three groups: the TOF group, the NMB was targeted to maintain two counts of train-of-four (TOF); the T1 group, maintain the T1/Tc (T1: amplitude of first twitch, Tc: amplitude of baseline twitch) ratio at 50%; and the N group, no relaxants after tracheal intubation. Successful LSR monitoring was defined as effective baseline establishment and maintenance of the LSR until dural opening.
RESULTS: The success rate of LSR monitoring was significantly lower in the TOF group. But, there was no significant difference between T1 and N. The detection rate of spontaneous free-run electromyography (EMG) activity was significantly higher in the N group compared with the TOF and T1 groups.
CONCLUSIONS: Partial NMB with a target of T1/Tc ratio at 50% allows good recording of LSR with same outcome as surgery without NMB, and reduced spontaneous EMG activity.
SIGNIFICANCE: We suggested the availability of partial NMB for intraoperative LSR monitoring.