title: A comparison of three induction regimens using succinylcholine, vecuronium, or no muscle relaxant: impact on the intraoperative monitoring of the lateral spread response in hemifacial spasm surgery: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Surgical microvascular decompression (MVD) is the curative treatment for hemifacial spasm (HFS). Monitoring MVD by recording the lateral spread response (LSR) intraoperatively can predict a successful clinical outcome. However, the rate of the LSR varies between trials, and the reason for this variation is unclear. The aim of our trial is to evaluate the rate of the LSR after intubation following treatment with succinylcholine, vecuronium, or no muscle relaxant.
  
  
  METHODS
  This trial is a prospective randomised controlled trial of 96 patients with HFS (ASA status I or II) undergoing MVD under general anaesthesia. Patients are randomised to receive succinylcholine, vecuronium, or no muscle relaxant before intubation. Intraoperative LSR will be recorded until dural opening. The primary outcome of this study is the rate of the LSR, and the secondary outcomes are post-intubation pharyngolaryngeal symptoms, the rate of difficult intubations, the rate of adverse haemodynamic events and the relationship between the measurement of LSR or not, and clinical success rates at 30 days after surgery.
  
  
  CONCLUSIONS
  This study aims to evaluate the impact of muscle relaxants on the rate of the LSR, and the study may provide evidence supporting the use of muscle relaxants before intubation in patients with HFS undergoing MVD surgery.
  
  
  BACKGROUND
  http://www.chictr.org/ ChiCTR-TRC-11001504 Date of registration: 24 June, 2011. The date the first patient was randomised: 30 September, 2011.
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang Street, Chengdu 610041, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Fang
authors.forename: Heng
authors.initials: H
authors.lastname: Zhang
authors.forename: Wenke
authors.initials: W
authors.lastname: Liu
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
mesh_terms: D000768:Anesthesia, General; D002681:China; D004558:Electric Stimulation; D004576:Electromyography; D005152:Facial Muscles / Q000294:innervation*; D005154:Facial Nerve / Q000503:physiopathology*; D005260:Female; D019569:Hemifacial Spasm / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D061145:Microvascular Decompression Surgery; D016343:Monitoring, Intraoperative / Q000379:methods; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D012107:Research Design; D013390:Succinylcholine / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D014673:Vecuronium Bromide / Q000008:administration & dosage*
chemical_list: D009467:Neuromuscular Depolarizing Agents; D014673:Vecuronium Bromide; D013390:Succinylcholine