Stinson L W, Murray M J, Jones K A, Assef S J, Burke M J, Behrens T L, Lennon R L
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905.
J Cardiothorac Vasc Anesth. 1994 Feb;8(1):40-4. doi: 10.1016/1053-0770(94)90010-8.
A microcomputer-controlled closed-loop infusion system (MCCLIS) has been developed that provides stable intraoperative levels of partial neuromuscular blockade. Complete neuromuscular blockade interferes with intraoperative motor-evoked potential (MEP) monitoring used for patients undergoing surgical procedures that place them at risk for spinal cord ischemia. Nine patients were studied during which the MCCLIS maintained stable levels of partial neuromuscular blockade and allowed transcranial magnetic motor-evoked potential (TcM-MEP) monitoring during thoracoabdominal aortic aneurysmectomy. The use of TcM-MEP for monitoring intraoperative spinal cord function was balanced against surgical considerations for muscle relaxation with 80% to 90% neuromuscular blockade fulfilling each requirement. Intraoperative adjustment of partial neuromuscular blockade to facilitate TcM-MEP monitoring was also possible with the MCCLIS. The MCCLIS should allow for further investigation into the sensitivity, specificity, and predictability of TcM-MEP monitoring for any patient at risk for intraoperative spinal cord ischemia including those undergoing thoracoabdominal aortic aneurysmectomy.
一种微机控制的闭环输注系统（MCCLIS）已被研发出来，它能在术中提供稳定的部分神经肌肉阻滞水平。完全神经肌肉阻滞会干扰用于接受手术的患者的术中运动诱发电位（MEP）监测，这些手术使患者有脊髓缺血的风险。对9名患者进行了研究，在此期间，MCCLIS维持了稳定的部分神经肌肉阻滞水平，并在胸腹主动脉瘤切除术中允许进行经颅磁运动诱发电位（TcM-MEP）监测。使用TcM-MEP监测术中脊髓功能与肌肉松弛的手术考虑因素相平衡，80%至90%的神经肌肉阻滞可满足每项要求。使用MCCLIS还可以在术中调整部分神经肌肉阻滞以促进TcM-MEP监测。MCCLIS应该允许对TcM-MEP监测对于任何有术中脊髓缺血风险的患者（包括那些接受胸腹主动脉瘤切除术的患者）的敏感性、特异性和可预测性进行进一步研究。
