A clinical investigation of the function of neuromuscular transmission during the neurosurgery of celebellopontine angle.

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During the neurosurgery around celebellopontine angle (CPA), to avoid the injury to facial nerve, a facial movement monitor (FEM) is used. However, too much muscle relaxation during anesthesia make it impossible to trace the facial nerve. The purpose of this study is to find the optimal degree of neuromuscular blockade during the operation.[Methods & Materials] The study included 19 adult patient undergoing CPA -neurosurgery. Prier to induction of anesthesia, neuromuscular monitoring (TOE Watch SX, Think Pad T30) were set at hand and foot, respectively. The index of optimal degree of neuromuscular blockade was evaluated by the first twitch of the response of train-of-four (TOF) stimulation and TOF responses counts.[Results & Conclusions) The incidences of FMM response when TOF count 0, 1, 2, 4 at hand were 10.2, 26.3, 74.4,100%, respectively. At foot, 4, 7, 17.6, 88.4, 100, 100%, respectively. Considering the diaphragm response, TOE cont 1, T1 value 8 10% at hand, TOF count 1 or 2, T1 values 15% are concluded as the indexes of optimal degree of neuromuscular blockade during FFM monitoring.