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

在小桥桥角周围神经外科手术中，为避免面神经损伤，采用了面部运动监测仪。然而，在麻醉过程中，肌肉过度松弛使得无法追踪面神经。本研究的目的是寻找手术中神经肌肉阻滞的最佳程度。【方法与材料】选取19例接受CPA -神经外科手术的成人患者为研究对象。麻醉诱导前，分别在手、足部设置神经肌肉监护仪（TOE Watch SX, Think Pad T30）。以四组训练（TOF）刺激反应的第一次抽搐和TOF反应计数来评价神经肌肉阻滞的最佳程度指标。[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%、74.4100%。在脚下，分别是4、7、17.6、88.4、100、100%。考虑膈肌反应，得出TOF计数1、T1值8 - 10%在手，TOF计数1或2、T1值15%作为FFM监测时神经肌肉阻断程度的最佳指标。

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.