Streinzer W, Gilly H, Redl G, Draxler V, Zrunek M, Höfler H
Laryngol Rhinol Otol (Stuttg). 1986 Nov;65(11):628-31.
To objectivate the clinical impression of different neuromuscular depression in the larynx- and limb-musculature, an attempt was made in 5 patients to quantify laryngeal muscle relaxation by electromyographic recordings of evoked responses from the vocalis muscle during endolaryngeal microsurgery. Mechanographic and evoked electromyographic recordings of the thenar muscles were obtained simultaneously. Nearly total suppression of evoked responses at the peripheral muscle site was observed after a bolus dose of either 60 micrograms/kg or 100 micrograms/kg of the nondepolarising muscle relaxant Vecuronium. However, the vocalis muscle was not blocked completely. The neuromuscular depression ranged from 61 to 92% depending on the dose. In no case was the recommended intubating dose (ED 95) of 60 micrograms/kg sufficient for complete relaxation of the vocalis muscle. The present results do not support that the extent and/or time course of intrinsic laryngeal muscle relaxation correlates with peripheral neuromuscular depression in a quantitative manner. The different degree of relaxation achieved by Vecuronium in the hand and larynx is probably due to their different content of acetylcholine receptors.
为了客观评估喉肌和肢体肌肉中不同程度的神经肌肉抑制情况，对5例患者进行了一项尝试，即在喉内显微手术期间，通过对声带肌诱发反应进行肌电图记录来量化喉肌松弛程度。同时获取了鱼际肌的力学记录和诱发肌电图记录。给予60微克/千克或100微克/千克非去极化肌松药维库溴铵单次推注后，在外周肌肉部位观察到诱发反应几乎完全被抑制。然而，声带肌并未被完全阻滞。根据剂量不同，神经肌肉抑制程度在61%至92%之间。60微克/千克的推荐插管剂量（ED 95）在任何情况下都不足以使声带肌完全松弛。目前的结果并不支持喉内肌松弛的程度和/或时间进程与外周神经肌肉抑制呈定量相关。维库溴铵在手部和喉部实现的不同程度的松弛可能是由于它们乙酰胆碱受体含量不同。
