title: Effects of partial neuromuscular blockade on lateral spread response monitoring during microvascular decompression surgery.
abstract: OBJECTIVE
  We evaluated the effect of partial neuromuscular blockade (NMB) and no NMB on successful intraoperative monitoring of the lateral spread response (LSR) during microvascular decompression (MVD) surgery.
  
  
  METHODS
  Patients were randomly allocated into one of three groups: the TOF group, the NMB was targeted to maintain two counts of train-of-four (TOF); the T1 group, maintain the T1/Tc (T1: amplitude of first twitch, Tc: amplitude of baseline twitch) ratio at 50%; and the N group, no relaxants after tracheal intubation. Successful LSR monitoring was defined as effective baseline establishment and maintenance of the LSR until dural opening.
  
  
  RESULTS
  The success rate of LSR monitoring was significantly lower in the TOF group. But, there was no significant difference between T1 and N. The detection rate of spontaneous free-run electromyography (EMG) activity was significantly higher in the N group compared with the TOF and T1 groups.
  
  
  CONCLUSIONS
  Partial NMB with a target of T1/Tc ratio at 50% allows good recording of LSR with same outcome as surgery without NMB, and reduced spontaneous EMG activity.
  
  
  CONCLUSIONS
  We suggested the availability of partial NMB for intraoperative LSR monitoring.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Yang Hoon
authors.initials: YH
authors.lastname: Chung
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ik Soo
authors.initials: IS
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kwan
authors.initials: K
authors.lastname: Park
authors.affiliation: Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seong Hyuk
authors.initials: SH
authors.lastname: Lim
authors.affiliation: Department of Neurology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Seo
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: jjeong.lee@samsung.com.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Song-I
authors.initials: SI
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D004576:Electromyography; D005152:Facial Muscles / Q000294:innervation / Q000601:surgery; D005154:Facial Nerve / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D019569:Hemifacial Spasm / Q000601:surgery*; D006801:Humans; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D019148:Neuromuscular Blockade / Q000379:methods*; D061886:Neuromuscular Monitoring / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Electromyography; Facial nerve; Microvascular decompression surgery; Neuromuscular blockade; Neuromuscular monitoring