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

小脑桥脑角神经外科手术中神经肌肉传递功能的临床研究。

• 批准号: 14571476
• 负责人: UEDA Naoyuki
• 金额: $ 1.73万
• 依托单位: KURUME UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14571476/
• 关键词: muscle relaxation; neuromuscular monitoring; neurosurgery; train-of-four刺激; 顔面神経モニタ

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.

在桥小脑角周围神经外科手术中，为避免面神经损伤，常使用面神经运动监测仪。然而，在麻醉过程中过度的肌肉松弛使得不可能追踪面神经。本研究的目的是寻找术中最佳的肌松程度。[方法与材料] 19例成人CPA -神经外科患者。麻醉诱导前，分别在手部和足部设置神经肌肉监测（TOE Watch SX，Think Pad T30）。以TOF反应的第一次抽搐次数和TOF反应计数作为评价最佳肌松程度的指标。[结果与结论] TOF计数为0、1、2、4时FMM反应发生率分别为10.2、26.3、74.4、100%。在足部，分别为4、7、17.6、88.4、100、100%。结合膈肌反应，认为TOE ≥ 1，T1值8 ~ 10%，TOF计数1 ~ 2，T1值15%可作为FFM监测时最佳肌松程度的指标。