Staff Anaesthesiologist, Department of Anaesthesiology, Sint-Vincentius Hospital, Affiliated to the University of Antwerp, Belgium.
Professor of Anaesthesiology.
Anaesthesia. 2010 Jun;65(6):601-607. doi: 10.1111/j.1365-2044.2010.06342.x.
We measured acceleromyography and mechanomyography simultaneously with monitoring of rocuronium-induced neuromuscular block in four patients with myotonic dystrophy type 1. Furthermore, we compared neuromuscular block measures from these patients with those from normal controls from previous studies. In myotonic dystrophy type 1 patients, the dose-response curve obtained with acceleromyography was steeper and right-shifted compared with that obtained using mechanomyography. However, the effective doses to produce 95% neuromuscular block determined with both acceleromyography and mechanomyography were similar to each other and to values found in normal patients. In the three myotonic dystrophy type 1 patients with mild to moderate disease, times to recovery from block were similar to those observed in normal controls. In both patients and normal controls, neuromuscular block recovered faster with acceleromyography. However, in one patient with severe muscle wasting, recovery of neuromuscular block was prolonged. We conclude that mechanomyography and acceleromyography cannot be used interchangeably to monitor neuromuscular block in myotonic dystrophy type 1 patients.
我们在 4 名 1 型肌强直性营养不良患者中同时进行加速度肌描记法和肌动描记法监测罗库溴铵诱导的神经肌肉阻滞，并将这些患者的神经肌肉阻滞测量值与之前研究中的正常对照组进行了比较。在 1 型肌强直性营养不良患者中，与肌动描记法相比，加速度肌描记法获得的剂量反应曲线更陡峭且右移。然而，两种方法确定产生 95%神经肌肉阻滞的有效剂量彼此相似，且与正常患者的值相似。在 3 名轻度至中度疾病的 1 型肌强直性营养不良患者中，阻滞恢复时间与正常对照组相似。在患者和正常对照组中，神经肌肉阻滞均随着加速度肌描记法而更快恢复。然而，在一名肌肉严重萎缩的患者中，神经肌肉阻滞的恢复时间延长。我们得出结论，不能交替使用肌动描记法和加速度肌描记法来监测 1 型肌强直性营养不良患者的神经肌肉阻滞。
