Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
J Reconstr Microsurg. 2012 Jul;28(6):387-93. doi: 10.1055/s-0032-1315761. Epub 2012 Jun 28.
This experiment establishes the principles of using the compound muscle action potential (CMAP) as a possible postoperative monitor for free muscle grafts. Twenty rabbits were divided into two groups of ten each to investigate the effects of ischemia on CMAP of the muscles. Rectus femoris model was used and contralateral muscle was used as control. In all muscles total normothermic ischemia of 1.5 hours to mimic the time needed for transfer and inset of the flap was followed by occlusion of the artery in one group and vein in another group after 3 hours. During this ischemia of 1 hour, the CMAP amplitudes decreased and the latencies were prolonged. Latency prolongation was detected within 10 minutes of total, arterial, or venous ischemia. During the revascularization, both amplitude and latency improved, but not to the original values at the start. The results show that CMAP monitoring can provide easily detectable, objective indication of vascular compromise to a muscle graft within as early as 10 minutes of total, arterial, and venous ischemia. Changes in latency are more constant and predictable compared with amplitude changes. This method can provide continuous monitoring and can be used in buried muscle grafts.
本实验确立了使用复合肌肉动作电位（CMAP）作为游离肌肉移植物术后监测指标的原则。20 只兔子分为两组，每组 10 只，以研究缺血对肌肉 CMAP 的影响。使用股直肌模型，对侧肌肉作为对照。所有肌肉均进行总常温缺血 1.5 小时，模拟皮瓣转移和插入所需的时间，然后在 3 小时后阻断一组动脉，另一组静脉。在 1 小时的缺血过程中，CMAP 幅度降低，潜伏期延长。在总缺血、动脉或静脉缺血 10 分钟内即可检测到潜伏期延长。在再灌注过程中，振幅和潜伏期均有所改善，但未恢复到起始时的原始值。结果表明，CMAP 监测可在总缺血、动脉和静脉缺血后 10 分钟内，对肌肉移植物的血管受压提供易于检测的客观指标。与振幅变化相比，潜伏期变化更稳定且可预测。这种方法可以提供连续监测，可用于埋植的肌肉移植物。
