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Titolo:
Intramuscular versus surface electromyography of the diaphragm for determining neuromuscular blockade
Autore:
Hemmerling, TM; Schmidt, J; Wolf, T; Hanusa, C; Siebzehnruebl, E; Schmitt, H;
Indirizzi:
Univ Erlangen Nurnberg, Dept Anesthesiol, Erlangen, Germany Univ Erlangen Nurnberg Erlangen Germany Anesthesiol, Erlangen, Germany Univ Erlangen Nurnberg, Dept Gynecol, Erlangen, Germany Univ Erlangen Nurnberg Erlangen Germany Dept Gynecol, Erlangen, Germany
Titolo Testata:
ANESTHESIA AND ANALGESIA
fascicolo: 1, volume: 92, anno: 2001,
pagine: 106 - 111
SICI:
0003-2999(200101)92:1<106:IVSEOT>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
ADDUCTOR POLLICIS MUSCLES; ORBICULARIS OCULI; CORRUGATOR SUPERCILII; ROCURONIUM; VECURONIUM; HUMANS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
8
Recensione:
Indirizzi per estratti:
Indirizzo: Hemmerling, TM Hotel Dieu, CHUM, 3840 Rue St Urbain, Montreal, PQ H2W 1T8,Canada Hotel Dieu 3840 Rue St Urbain Montreal PQ Canada H2W 1T8 da
Citazione:
T.M. Hemmerling et al., "Intramuscular versus surface electromyography of the diaphragm for determining neuromuscular blockade", ANESTH ANAL, 92(1), 2001, pp. 106-111

Abstract

We determined the neuromuscular blockade of 0.2 mg.kg(-1) mivacurium at the diaphragm by using two new methods of electromyographic (EMG) monitoring and compared it with acceleromyography of the orbicularis oculi (OO) and the corrugator supercilii (CS) muscle. After the induction of anesthesia in 15 patients undergoing gynecologic laparoscopic surgery, evoked EMG responses at the diaphragm were obtained by using skin electrodes at the back of the patient, placed lateral to T12/L1 or L1/L2, and a laparoscopically applied wire electrode inserted into the dorsolateral portion of the diaphragm. Acceleromyography at the right OO and the left CS was performed. The facial and phrenic nerves were stimulated transcutaneously (onset: every 10 s, offset: every 15 s, single twitch stimulation). Lag and onset time, peak effect, and clinical duration (time to reach 75% of control value and time to reach 90% of control value) were measured and the results were compared by using analysis of variance; P < 0.05 showed significant difference. Pearson'scorrelation test and the Bland-Altman test were used to compare the two diaphragmatic monitoring methods. Mean peak effects of >98% were reached at all sites. Onset times at diaphragm (skin, IM) were significantly (P < 0.005) shorter than at the CS or OO (100 +/- 14 s and 98 +/- 16 s vs 147 +/- 39 s, 185 +/- 38 s) without being statistically different between OO and CS. There was a good correlation of lag, onset time, time to reach 75% of control value, and time to reach 90% of control value (r = 0.8, 0.9, 0.8, and 0.75; P < 0.01) between the two diaphragmatic methods. Mean difference and limits of agreements are -2 +/- 15 s, 1 +/- 21 s, -1 +/- 2.3 min, and -2 +/- 3.4 min. We showed a shorter onset and clinical duration at the diaphragm incomparison with CS and OO. Two methods of EMG of the diaphragm correlated well and showed good comparability. The novel method of surface diaphragmatic EMG at the patient's back maybe useful during routine clinical anesthesia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 04:22:33