肌松药是全麻方案中确保患者绝对制动的重要组成部分，然而肌松药对面神经诱发肌电位（EEMG）监测的影响限制了它们在面神经相关手术中的应用。因此，研究如何选择性减少肌松药对面神经-肌肉神经信号传导的影响，而保留肌松药对四肢骨骼肌的肌肉松弛作用具有重要的意义。我们前期研究发现：面肌和肢体骨骼肌对肌松药敏感性存在差异，造成这种差异的机制包括肌肉终板区乙酰胆碱受体（AChR）对肌松药亲和力、AChR密度以及突触前膜乙酰胆碱释放的差异,并且在受损时后两者也发生了改变。本项目拟进一步研究面肌和骨骼肌AChR对肌松药亲和力的差异是否与AChR亚基构成比相关；不同损伤程度面神经支配的肌肉AChR亚基构成比、表达特征与其EEMG反应的关系；受损面神经突触前膜乙酰胆碱释放机制的改变是否介导了肌松药对乙酰胆碱释放抑制的敏化。本项目对临床上实施面神经监测的手术中肌松药的合理使用具有重要的意义。

Muscle relaxant is one of the most important ingredients in general anesthesia to ensure the absolute immobility of the patient, while the influence of muscle relaxants on facial nerve evoked electromyographic (EEMG) monitoring limits their usage in the related surgeries. Therefore, there is important significance to investigate the way to selectively reduce the influence of muscle relaxants on facial neuromuscular transmission while keep the limb skeletal muscle relaxing. Our previous research indicated that differences in sensitivities to muscle relaxants existed between facial-nerve-innervated muscles and somatic-nerve-innervated muscles, which might be related to the affinity of acetylcholine receptors (AChR) to muscle relaxant, the destity of AChR at end-plates, and the presynaptic quantal release of acetylcholine, and the later two factors were altered when the facial nerve had been injured. The current research is designed to investigate the hypothesis as follows: First, whether the different affinity of AChR at end-plates to muscle rlaxants between the facial-nerve-innervated muscles and somatic-nerve-innervated muscles is related to the different composition of AChR subunits. Second, whether the changes in EEMG responses in facial nerves under different extents of injuries is related to the composition of AChR subunits and the character of their expressions. Finally, whether the sensitization of the inhibition on acetylcholine release in injured facial nerves by muscle relaxants is mediated by the changes of the patterns of presynaptic acetylcholine release. The results of the study are of significant importance to determine a proper strategy for rational usage of muscle relaxants in general anesthesia for the surgeries requiring EEMG monitoring.