Intraoperative monitoring of tibialis anterior muscle motor evoked responses to transcranial electrical stimulation during partial neuromuscular blockade.
Identifieur interne : 000218 ( Ncbi/Curation ); précédent : 000217; suivant : 000219Intraoperative monitoring of tibialis anterior muscle motor evoked responses to transcranial electrical stimulation during partial neuromuscular blockade.
Auteurs : C J Kalkman [Pays-Bas] ; J C Drummond ; N A Kennelly ; P M Patel ; B L PartridgeSource :
- Anesthesia and analgesia [ 0003-2999 ] ; 1992.
Descripteurs français
- KwdFr :
- MESH :
- pharmacologie : Muscles, Vécuronium.
- physiologie : Cortex moteur, Jonction neuromusculaire, Motoneurones.
- Adulte, Adulte d'âge moyen, Humains, Jambe, Jonction neuromusculaire, Potentiels évoqués, Stimulation électrique, Surveillance peropératoire.
English descriptors
- KwdEn :
- MESH :
- chemical , pharmacology : Vecuronium Bromide.
- drug effects : Neuromuscular Junction.
- innervation : Muscles.
- physiology : Motor Cortex, Motor Neurons, Neuromuscular Junction.
- Adult, Electric Stimulation, Evoked Potentials, Humans, Leg, Middle Aged, Monitoring, Intraoperative.
Abstract
We studied the feasibility of recording motor evoked responses to transcranial electrical stimulation (tce-MERs) during partial neuromuscular blockade (NMB). In 11 patients, compound muscle action potentials were recorded from the tibialis anterior muscle in response to transcranial electrical stimulation during various levels of vecuronium-induced NMB. The level of NMB was assessed by accelerometry of the adductor pollicis muscle after train-of-four stimulation of the ulnar nerve. The compound muscle action potential was also recorded from the tibialis anterior muscle after direct stimulation of the peroneal nerve (M-response) as an alternative means of assessing the degree of NMB. In all patients, tce-MERs could be recorded reliably during anesthesia with N2O and a continuous infusion of sufentanil (0.5 micrograms.kg-1.h-1). An intact train-of-four was present in all patients, and the amplitude of the first twitch was recorded and designated as the control value. Before administration of vecuronium, the M-response amplitude was 9.6 +/- 3.6 (mean +/- SD) mV, and the tce-MER amplitude was 1.21 +/- 0.66 mV. Although administration of vecuronium (0.05 mg/kg) resulted in loss of the mechanical adductor pollicis response in 8 of the 11 patients, the M-response and the tce-MER remained recordable. Subsequently, during an infusion of vecuronium, adjusted to maintain one or two mechanical responses to train-of-four stimulation, the average M-response to peroneal nerve stimulation was 5.2 +/- 2.5 mV (53% of the control value), and tce-MER amplitude was 0.59 +/- 0.36 mV (59% of the control value).(ABSTRACT TRUNCATED AT 250 WORDS)
DOI: 10.1213/00000539-199210000-00021
PubMed: 1356320
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A" uniqKey="Kennelly N" first="N A" last="Kennelly">N A Kennelly</name></author><author><name sortKey="Patel, P M" sort="Patel, P M" uniqKey="Patel P" first="P M" last="Patel">P M Patel</name></author><author><name sortKey="Partridge, B L" sort="Partridge, B L" uniqKey="Partridge B" first="B L" last="Partridge">B L Partridge</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1992">1992</date><idno type="RBID">pubmed:1356320</idno><idno type="pmid">1356320</idno><idno type="doi">10.1213/00000539-199210000-00021</idno><idno type="wicri:Area/PubMed/Corpus">002945</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002945</idno><idno type="wicri:Area/PubMed/Curation">002945</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002945</idno><idno type="wicri:Area/PubMed/Checkpoint">002803</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" 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J C" uniqKey="Drummond J" first="J C" last="Drummond">J C Drummond</name></author><author><name sortKey="Kennelly, N A" sort="Kennelly, N A" uniqKey="Kennelly N" first="N A" last="Kennelly">N A Kennelly</name></author><author><name sortKey="Patel, P M" sort="Patel, P M" uniqKey="Patel P" first="P M" last="Patel">P M Patel</name></author><author><name sortKey="Partridge, B L" sort="Partridge, B L" uniqKey="Partridge B" first="B L" last="Partridge">B L Partridge</name></author></analytic><series><title level="j">Anesthesia and analgesia</title><idno type="ISSN">0003-2999</idno><imprint><date when="1992" type="published">1992</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Electric Stimulation</term><term>Evoked Potentials</term><term>Humans</term><term>Leg</term><term>Middle Aged</term><term>Monitoring, Intraoperative</term><term>Motor Cortex (physiology)</term><term>Motor Neurons 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xml:lang="en"><term>Muscles</term></keywords><keywords scheme="MESH" qualifier="pharmacologie" xml:lang="fr"><term>Muscles</term><term>Vécuronium</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Cortex moteur</term><term>Jonction neuromusculaire</term><term>Motoneurones</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Motor Cortex</term><term>Motor Neurons</term><term>Neuromuscular Junction</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Electric Stimulation</term><term>Evoked Potentials</term><term>Humans</term><term>Leg</term><term>Middle Aged</term><term>Monitoring, Intraoperative</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Humains</term><term>Jambe</term><term>Jonction neuromusculaire</term><term>Potentiels évoqués</term><term>Stimulation électrique</term><term>Surveillance peropératoire</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We studied the feasibility of recording motor evoked responses to transcranial electrical stimulation (tce-MERs) during partial neuromuscular blockade (NMB). In 11 patients, compound muscle action potentials were recorded from the tibialis anterior muscle in response to transcranial electrical stimulation during various levels of vecuronium-induced NMB. The level of NMB was assessed by accelerometry of the adductor pollicis muscle after train-of-four stimulation of the ulnar nerve. The compound muscle action potential was also recorded from the tibialis anterior muscle after direct stimulation of the peroneal nerve (M-response) as an alternative means of assessing the degree of NMB. In all patients, tce-MERs could be recorded reliably during anesthesia with N2O and a continuous infusion of sufentanil (0.5 micrograms.kg-1.h-1). An intact train-of-four was present in all patients, and the amplitude of the first twitch was recorded and designated as the control value. Before administration of vecuronium, the M-response amplitude was 9.6 +/- 3.6 (mean +/- SD) mV, and the tce-MER amplitude was 1.21 +/- 0.66 mV. Although administration of vecuronium (0.05 mg/kg) resulted in loss of the mechanical adductor pollicis response in 8 of the 11 patients, the M-response and the tce-MER remained recordable. Subsequently, during an infusion of vecuronium, adjusted to maintain one or two mechanical responses to train-of-four stimulation, the average M-response to peroneal nerve stimulation was 5.2 +/- 2.5 mV (53% of the control value), and tce-MER amplitude was 0.59 +/- 0.36 mV (59% of the control value).(ABSTRACT TRUNCATED AT 250 WORDS)</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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