Effects of partial neuromuscular blockade on facial nerve monitorization in otologic surgery
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Taylor & Francis As
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective-Neuromuscular blockade (NMB) is administered as part of a general anesthetic in order to keep the Patient immobilized during surgery and has been known to hinder intraoperative neuromonitorization. The aim of this study was to determine the effects of different levels of NMB on electrical stimulation thresholds of the facial nerve during otologic surgery. Material and Methods-Intraoperative facial nerve monitorization was performed in 29 patients with advanced middle ear disease. Electromyographic (EMG) responses were recorded by insertion of needle electrodes into the orbicularis oris and orbicularis oculi muscles. Minimal facial nerve stimulations causing EMG responses in the facial musculature were measured during full recovery from the effects of muscular relaxants and with 25%, 50%, 75% and 100% levels of NMB. These defined NMB levels were maintained by the administration of a drip infusion of atracurium and were assessed objectively by recording the hypothenar muscle action. Results-All of the patients had detectable EMG responses of the facial musculature at the 50% and 75% levels of NMB in response to the electrical stimulation of the facial nerve. The corresponding mean stimulation thresholds were 0.10 +/- 0.08 and 0.11 +/- 0.09 mA, respectively. No responses were measured in 31% of the patients when the level of peripheral NMB was 100%. Conclusion-This study suggests that a regulated 50% level of peripheral NMB provides reliable intraoperative EMG monitoring of the facial musculature in response to electrical stimulation and adequate anesthesia, with full immobilization of the patient.
Açıklama
Collegium on Oto-Rhino-Laryngologicum Amicitiae Sacrum -- AUG 25-28, 2002 -- NOORDWIJIK, NETHERLANDS
Anahtar Kelimeler
facial nerve monitoring, neuromuscular blockade, otology, surgery
Kaynak
Acta Oto-Laryngologica
WoS Q Değeri
Q2
Scopus Q Değeri
N/A
Cilt
123
Sayı
2
