Shi Yongbing, Hou Vivian, Tucker Anne, Cohen James
Department of Otolaryngology, Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA.
Laryngoscope. 2008 Dec;118(12):2156-60. doi: 10.1097/MLG.0b013e318184574e.
To compare electromyographic (EMG) amplitude changes in extremity and laryngeal muscles after vecuronium administration and study the effects of topical lidocaine on laryngeal EMG in a swine model.
Prospective animal study.
Electrically evoked EMG activities were recorded from the vocalis muscles (directly and via an EMG endotracheal tube) and from the flexor digitorum muscles before and after intravenous vecuronium administration. EMG amplitudes were followed for 30 minutes after vecuronium injection together with monitoring of limb twitches to train-of-four stimulation. The testing was repeated after a 30-minute wash-out period and with topical lidocaine.
EMG amplitude recovery occurred sooner and more quickly in flexor digitorum muscle than in vocalis muscles. Reappearance of four twitches corresponded to EMG amplitude recovery to about 80% of the baseline in flexor digitorum muscles and to about half-baseline size in vocalis muscles. EMG amplitudes were generally lower at the start of the second round testing than the first round, with somewhat slower recovery in vocalis muscles.
In contrast to reports by others in human studies, extremity muscles seem to be more resistant to vecuronium at 0.1 mg/kg than laryngeal muscles in the swine. Reappearance of four twitches corresponds to 50% of laryngeal EMG recovery and indicates adequate condition for monitoring electrically evoked laryngeal EMG activities. This study is inconclusive regarding the effects of topically applied lidocaine on laryngeal EMG amplitudes. Translation of these data to humans should be done with caution.
比较维库溴铵给药后四肢肌肉和喉部肌肉的肌电图（EMG）幅度变化，并研究局部应用利多卡因对猪模型喉部肌电图的影响。
前瞻性动物研究。
在静脉注射维库溴铵前后，记录拇长屈肌（直接记录和通过肌电图气管内导管记录）和声带肌的电诱发肌电图活动。注射维库溴铵后，连续30分钟监测肌电图幅度，并监测四肢对四个成串刺激的抽搐反应。在30分钟的洗脱期后，重复进行测试，并使用局部利多卡因。
拇长屈肌的肌电图幅度恢复比声带肌更快更早。四个抽搐反应的再次出现对应于拇长屈肌的肌电图幅度恢复到基线的约80%，声带肌的幅度恢复到基线的约一半。在第二轮测试开始时，肌电图幅度总体上低于第一轮，声带肌的恢复稍慢。
与其他人在人体研究中的报告相反，在猪中，0.1mg/kg的维库溴铵对四肢肌肉的作用似乎比对喉部肌肉更具耐受性。四个抽搐反应的再次出现对应于喉部肌电图恢复的50%，表明监测电诱发喉部肌电图活动的条件良好。本研究关于局部应用利多卡因对喉部肌电图幅度的影响尚无定论。将这些数据外推至人体时应谨慎。
