Beemer G H, Reeves J H, Bjorksten A R
Department of Anaesthesia, Royal Melbourne Hospital, Victoria, Australia.
Anaesth Intensive Care. 1990 Nov;18(4):490-6. doi: 10.1177/0310057X9001800414.
For normal anaesthetic practice, monitoring of neuromuscular blockade is best performed by stimulation of the ulnar nerve at the wrist with a peripheral nerve stimulator and evaluation of the response of the thumb. Determination of the initial threshold for stimulation in the awake patient to allow estimation of the current required for supramaximal stimulation is an important set-up procedure to improve accuracy. The degree of paralysis of specific muscle groups such as the diaphragm can be inferred from their sensitivity to neuromuscular blocking agents relative to adductor pollicis. Monitoring with different stimulation patterns allows a wide spectrum of muscle paralyses to be evaluated.
对于常规麻醉操作，监测神经肌肉阻滞的最佳方法是使用外周神经刺激器刺激腕部的尺神经，并评估拇指的反应。确定清醒患者的初始刺激阈值，以便估计超强刺激所需的电流，是提高准确性的一项重要准备程序。特定肌肉群（如膈肌）的麻痹程度可根据其相对于拇内收肌对神经肌肉阻滞剂的敏感性来推断。采用不同的刺激模式进行监测，可以评估广泛的肌肉麻痹情况。
