Brauer M, Knuettgen D, Quester R, Doehn M
Department of Anaesthesia, Friedrich Schiller University of Jena, Germany.
Eur J Anaesthesiol. 1996 Nov;13(6):612-5. doi: 10.1046/j.1365-2346.1996.00010.x.
The facial nerve is monitored intra-operatively using electromyography to identify and prevent damage during the excision of an acoustic neurinoma. In order to determine whether a profound level of peripheral neuromuscular blockade could be achieved without compromising facial electromyographic monitoring, 11 patients undergoing resection of acoustic neurinoma were studied. After induction of anaesthesia, an infusion of atracurium was administered to reduce the integrated electrically evoked muscle potential (EEMP) of the hypothenar eminence by 70-100%. The facial nerve was directly stimulated in the surgical field and the facial evoked muscle potentials (EMPs) were recorded. Even under complete peripheral neuromuscular blockade (i.e. no electrically evoked muscle potential measurable over the hypothenar eminence, no palpable hypothenar muscle response) it was possible to evoke facial muscle electromyographic responses by stimulation of the facial nerve.
术中使用肌电图监测面神经，以在切除听神经瘤时识别并防止损伤。为了确定在不影响面神经肌电图监测的情况下是否能达到深度外周神经肌肉阻滞，对11例接受听神经瘤切除术的患者进行了研究。麻醉诱导后，输注阿曲库铵以使小鱼际肌的综合电诱发肌肉电位（EEMP）降低70%至100%。在手术区域直接刺激面神经并记录面部诱发肌肉电位（EMP）。即使在外周神经肌肉完全阻滞的情况下（即小鱼际肌无可测量的电诱发肌肉电位，无可触及的小鱼际肌反应），通过刺激面神经仍有可能诱发面部肌肉肌电图反应。
