A preliminary clinical evaluation of magnetic stimulation of the ulnar nerve for monitoring neuromuscular transmission.
The evoked motor responses to magnetic and electrical peripheral nerve stimuli were quantitatively assessed after vecuronium in 15 women undergoing gynaecological surgery. Anaesthesia was induced with thiopentone and fentanyl and maintained with intermittent doses of fentanyl and 66% nitrous oxide in oxygen. After immobilisation of both forearms in splints, the ulnar nerves were stimulated supramaximally every 10 s with a magnetic stimulator (Magstim Model 200) and an electric stimulator (Myotest) on opposite sides. The adduction forces of both thumbs to magnetic and electric stimuli were measured simultaneously before and after 0.06 mg.kg-1 of vecuronium. After vecuronium administration the twitch responses to magnetic stimulation decreased more slowly than those to electric stimulation. The difference in the evoked responses between the two types of stimulation was approximately 20% overall and was significant 2 min after vecuronium administration (p < 0.05). The rate of recovery of the evoked twitch responses was more rapid with magnetic than electric stimulation. It is concluded that magnetic stimulation of peripheral nerve is a useful technique for evaluating residual neuromuscular blockade.
Department of Anesthesiology, Sapporo Medical University, School of Medicine, Japan.
H
H
Iwasaki
M
M
Igarashi
A
A
Namiki
D000328:Adult; D004558:Electric Stimulation; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D006801:Humans; D008280:Magnetics; D009469:Neuromuscular Junction / Q000502:physiology*; D009435:Synaptic Transmission; D014459:Ulnar Nerve / Q000502:physiology*; D014673:Vecuronium Bromide / Q000494:pharmacology
D014673:Vecuronium Bromide