Nydahl P A, Axelsson K, Hallgren S, Larsson P G, Leissner P, Philipson L
Department of Anaesthesiology, Orebro Medical Centre Hospital, Sweden.
Acta Anaesthesiol Scand. 1988 Aug;32(6):477-84. doi: 10.1111/j.1399-6576.1988.tb02770.x.
Methods for assessing motor blockade by means of isometric force measurements and surface electromyographic (EMG) recordings in the lower extremities and abdominal wall were evaluated in 30 volunteers. The coefficients of variation were 10% for force measurements and 14% and 20% for average rectified EMG (RIEMG) recordings over the quadriceps muscle and abdominal muscles, respectively, and 8% overall for TURNS (the number of changes in the sign of the direction of the EMG signal). Seven of the 30 volunteers received epidural anaesthesia with 20 ml of mepivacaine 2% with adrenaline. The mean maximal cephalad analgesic level was T9. At that abdominal segment, RIEMG showed a reduction of 50% and TURNS of 20%. Isometric force and RIEMG recorded simultaneously in the quadriceps muscles during epidural anaesthesia displayed a linear relationship with a correlation coefficient of 0.91. TURNS was insensitive to force variations above 60% of maximum voluntary contraction. During the regression phase, 90% of both the initial force and RIEMG value was noted 180 min after the epidural injection. It is concluded that recording of RIEMG is a good method for quantitative assessment of motor blockade during epidural anaesthesia.
通过等长肌力测量和下肢及腹壁表面肌电图（EMG）记录来评估运动阻滞的方法，在30名志愿者身上进行了评估。肌力测量的变异系数为10%，股四头肌和腹部肌肉的平均整流肌电图（RIEMG）记录的变异系数分别为14%和20%，而肌电图信号方向符号变化次数（TURNS）的总体变异系数为8%。30名志愿者中有7人接受了20毫升含肾上腺素的2%甲哌卡因硬膜外麻醉。平均最大头侧镇痛平面为T9。在该腹部节段，RIEMG显示降低了50%，TURNS降低了20%。硬膜外麻醉期间股四头肌同时记录的等长肌力和RIEMG呈现线性关系，相关系数为0.91。TURNS对超过最大自主收缩60%的肌力变化不敏感。在恢复阶段，硬膜外注射后180分钟时，初始肌力和RIEMG值均有90%恢复。结论是，RIEMG记录是硬膜外麻醉期间运动阻滞定量评估的一种好方法。
