Hemmerling Thomas M, Michaud Guillaume, Babin Denis, Trager Guillaume, Donati François
Neuromuscular Research Group, Department of Anesthesiology, Centre hospitalier de l'université de Montréal, Hôtel-Dieu, Université de Montréal, Montréal, Québec, Canada.
Can J Anaesth. 2004 Feb;51(2):116-21. doi: 10.1007/BF03018768.
Phonomyography is based on the creation of low frequency sounds during muscle contraction, which can be recorded and used for neuromuscular monitoring. In this study, balloon pressure mechanomyography, a novel method to measure the force of contraction via pressure changes in an air-filled balloon, was compared with phonomyography to determine neuromuscular blockade at the corrugator supercilii muscle.
After approval of the Ethics Committee and informed consent, 15 patients were studied. A small condenser microphone was taped to the area just above the eyebrow for phonomyography; an air-filled balloon was taped to the area just above the opposite eyebrow. After induction of anesthesia using remifentanil and propofol, a laryngeal mask airway was inserted without the aid of neuromuscular blocking agents. The facial nerve was stimulated supramaximally with single-twitch stimulation (0.1 Hz) using superficial electrodes placed on both temporal areas for onset and train-of-four stimulation every 12 sec during offset of neuromuscular blockade produced by mivacurium 0.1 mg.kg(-1). Onset and recovery measured by the two methods were compared using the t test and agreement between phonomyography and balloon pressure mechanomyography was examined using the Bland-Altman method.
Onset, peak effect, and time to reach 25%, 75%, and 90% of control twitch response for phonomyography vs balloon pressure method were 83 +/- 16 sec vs 81 +/- 15 sec, 80 +/- 15% vs 82 +/- 17%, 7.7 +/- 2.3 min vs 7.5 +/- 2.4 min, 9.9 +/- 4.1 min vs 10.5 +/- 4 min, and 12.6 +/- 4.3 min vs 13.1 +/- 4.5 min respectively without being significantly different. Mean bias was 1% with limits of agreement of -9 and +9% of twitch height (T1).
We applied a balloon pressure method to measure the force at the corrugator supercilii. Phonomyography at the corrugator supercilii shows good agreement with this modified version of mechanomyography.
肌音描记法基于肌肉收缩时产生的低频声音，这些声音可被记录并用于神经肌肉监测。在本研究中，将球囊压力机械肌动描记法（一种通过充气球囊内压力变化来测量收缩力的新方法）与肌音描记法进行比较，以确定皱眉肌的神经肌肉阻滞情况。
经伦理委员会批准并获得知情同意后，对15例患者进行研究。将一个小型电容式麦克风粘贴在眉毛上方区域用于肌音描记法；将一个充气球囊粘贴在对侧眉毛上方区域。使用瑞芬太尼和丙泊酚诱导麻醉后，在不使用神经肌肉阻滞剂的情况下插入喉罩气道。使用置于双侧颞部的表面电极，以单次颤搐刺激（0.1Hz）对面神经进行超强刺激，在0.1mg·kg⁻¹米库氯铵产生神经肌肉阻滞消退期间，每12秒进行一次四个成串刺激。使用t检验比较两种方法测得的起效时间和恢复时间，并使用Bland-Altman方法检验肌音描记法与球囊压力机械肌动描记法之间的一致性。
肌音描记法与球囊压力法相比，起效时间、峰值效应以及达到对照颤搐反应的25%、75%和90%的时间分别为83±16秒对81±15秒、80±15%对82±17%、7.7±2.3分钟对7.5±2.4分钟、9.9±4.1分钟对10.5±4分钟、12.6±4.3分钟对13.1±4.5分钟，差异均无统计学意义。平均偏差为1%，一致性界限为颤搐高度（T1）的-9%至+9%。
我们应用球囊压力法测量皱眉肌的力量。皱眉肌的肌音描记法与这种改良的机械肌动描记法显示出良好的一致性。
