Fabregat López J, Porta Vila G, Martin-Flores M
Department of Anesthesia and Perioperative Care, Complejo Hospitalario Universitario Santa Lucía/Santa María del Rosell, Cartagena, Murcia, Spain.
Rev Esp Anestesiol Reanim. 2013 Oct;60(8):465-8. doi: 10.1016/j.redar.2012.12.005. Epub 2013 May 8.
We report two cases in which moderate and intense rocuronium-induced neuromuscular block was reversed intraoperatively with low sugammadex doses in order to facilitate electromyographic evaluation of facial nerve function during surgery of the parotid gland and the middle ear. Acceleromyography was used to assess reversal of neuromuscular block before starting electromyography monitoring. Rocuronium-induced neuromuscular block was reversed with sugammadex 0.22mgkg(-1) when the TOF ratio was 0.14 in the first patient, and with sugammadex 2mgkg(-1) during intense block (PTC 0) in the second patient. In each case, appropriate neuromuscular function (TOF ratio≥0.9) was established soon after sugammadex administration, and electromyographic evaluation of facial nerve was successfully conducted. The use of rocuronium and sugammadex, coupled with objective neuromuscular monitoring with acceleromyography, assured complete restoration of neuromuscular function and created the optimal conditions for the surgical team.
我们报告了两例在腮腺和中耳手术期间，为便于术中对面神经功能进行肌电图评估，使用低剂量舒更葡糖在术中逆转中度和深度罗库溴铵诱导的神经肌肉阻滞的病例。在开始肌电图监测之前，使用加速度肌电图来评估神经肌肉阻滞的逆转情况。第一例患者在四个成串刺激（TOF）比值为0.14时，用0.22mg/kg的舒更葡糖逆转罗库溴铵诱导的神经肌肉阻滞；第二例患者在深度阻滞（强直后计数为0）期间，用2mg/kg的舒更葡糖逆转。在每种情况下，舒更葡糖给药后很快就建立了适当的神经肌肉功能（TOF比值≥0.9），并成功地对面神经进行了肌电图评估。罗库溴铵和舒更葡糖的使用，再加上加速度肌电图进行客观的神经肌肉监测，确保了神经肌肉功能的完全恢复，并为手术团队创造了最佳条件。
