Smith D C
Department of Anaesthesia, Plymouth General Hospital, Plymouth, UK.
Eur J Anaesthesiol. 1993 Sep;10(5):371-4.
Changes in electrical impedance at the recording electrodes have been blamed for the failure of evoked electromyographic responses to return to baseline during the offset of neuromuscular block, but a relationship between electrode impedance and electromyographic responses has never been shown. In 50 fit adults, the resistive and capacitive (reactive) components of the impedance of the recording electrodes were measured during electromyographic monitoring of neuromuscular transmission under enflurane anaesthesia. In 25 patients six 1 mm-deep punctures were made in the skin under both active recording electrodes, and in the other 25 no puncture was made. Electrode impedance was measured using an impedance bridge at a current density less than 60 microA cm-2. Skin puncture made no difference either to the electrode impedance, or to the decrement from the baseline of the first electromyographic response to the train-of-four stimuli after offset of neuromuscular blockade. The electrode impedance decreased in 48 of the patients, and increased slightly in the other two patients. There was no relationship between the decrease in the T1 response from baseline and the change in electrode impedance during electromyographic monitoring.
记录电极处电阻抗的变化被认为是在神经肌肉阻滞消退期间诱发肌电图反应未能恢复到基线水平的原因,但电极阻抗与肌电图反应之间的关系从未得到证实。在50名健康成年人中,在恩氟烷麻醉下进行神经肌肉传递的肌电图监测时,测量了记录电极阻抗的电阻性和电容性(电抗性)成分。在25名患者中,在两个有源记录电极下方的皮肤进行了6次1毫米深的穿刺,另外25名患者未进行穿刺。使用阻抗电桥在电流密度小于60微安/平方厘米的情况下测量电极阻抗。皮肤穿刺对电极阻抗或神经肌肉阻滞消退后对四个成串刺激的第一个肌电图反应相对于基线的衰减均无影响。48名患者的电极阻抗降低,另外两名患者略有增加。在肌电图监测期间,T1反应相对于基线的降低与电极阻抗的变化之间没有关系。