Simultaneous determination of neuromuscular block at the larynx, diaphragm, adductor pollicis, orbicularis oculi and corrugator supercilii muscles.
We simultaneously determined the neuromuscular blocking effect of mivacurium 0.2 mg kg(-1) at five muscles in 20 women undergoing gynaecological surgery. Evoked electromyographic responses were obtained using surface electromyography (EMG) at the adducting laryngeal muscles, the diaphragm (lateral to vertebrae T12/L1 or L1/L2) and the adductor pollicis muscle and acceleromyographic (AMG) responses were measured at the orbicularis oculi and the corrugator supercilii muscle. Onset time and times for the first twitch response (T1/T0) to return to 25, 75 and 90% at the adducting laryngeal muscles and the diaphragm were significantly (P<0.005) shorter than at the adductor pollicis, the corrugator supercilii or the orbicularis oculi muscles (mean (SD) onset time: 89 (26) s and 78 (17) s to 202 (45) s, 152 (41) s, 194 (40) s; T1/T0=25%: 10.4 (1.5) and 11.4 (1.2) min versus 20.5 (3.9), 15.9 (3.3), 16.3 (3.7) min; T1/T0=90%: 15.5 (1.6) and 16.1 (1.6) min versus 27.4 (4.6), 21.5 (3.8), 23.3 (5.1) min). Onsetand clinical duration of neuromuscular block at the larynx and the diaphragm after mivacurium 0.2 mg kg(-1) are shorter than in the peripheral muscles. Monitoring of neuromuscular block in the diaphragm was successfully used in all patients.
Hemmerling
T M
TM
Department of Anaesthesiology, University Erlangen-Nuremberg, Germany.
Schmidt
J
J
Hanusa
C
C
Wolf
T
T
Schmitt
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D003964:Diaphragm / Q000187:drug effects; D004566:Electrodes; D004576:Electromyography / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007546:Isoquinolines / Q000494:pharmacology*; D007830:Larynx / Q000187:drug effects; D008875:Middle Aged; D000077590:Mivacurium; D016343:Monitoring, Intraoperative / Q000379:methods*; D018482:Muscle, Skeletal / Q000187:drug effects; D009132:Muscles / Q000187:drug effects*; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*
D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium