PMID- 23378247
OWN - NLM
STAT- MEDLINE
DCOM- 20130509
LR  - 20220408
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Linking)
VI  - 110
IP  - 4
DP  - 2013 Apr
TI  - Comparison of motor-evoked potentials monitoring in response to transcranial 
      electrical stimulation in subjects undergoing neurosurgery with partial vs no 
      neuromuscular block.
PG  - 567-76
LID - 10.1093/bja/aes395 [doi]
AB  - BACKGROUND: There have been no evidence-based comparisons of motor-evoked 
      potential (MEP) monitoring with no and partial neuromuscular block (NMB). We 
      compared the effects of different levels of NMB including no NMB on MEP 
      parameters. METHODS: MEP-monitored 120 patients undergoing neurosurgery were 
      enrolled. The patients were randomly allocated to four groups: Group A was to 
      maintain two train-of-four (TOF) counts; Group B was to maintain a T(1)/Tc of 
      0.5; Group C was to maintain a T(2)/Tc of 0.5 (T(1,2), first or second twitch 
      height of TOF; Tc, control twitch height); Group D did not maintain NMB. The mean 
      MEP amplitude, coefficient of variation (CV), the incidence of spontaneous 
      respiration or movement, the efficacy of MEP, and haemodynamic parameters were 
      compared. RESULTS: The median [inter-quartile range (IQR)] amplitudes of the left 
      leg for Groups A, B, C, and D were 0.23 (0.15-0.57), 0.44 (0.19-0.79), 0.28 
      (0.15-0.75), and 0.75 (0.39-1.35) mV, respectively. The median (IQR) CVs of the 
      left leg were 71.1 (56.9-88.8), 76.1 (54.2-93.1), 59.8 (48.6-95.6), and 25.2 
      (17.3-35.0), respectively. The differences between groups of the mean amplitudes 
      of the left arm and both legs were statistically significant (Kruskal-Wallis 
      test, P=0.011 for the left leg). For all limbs, the differences between groups of 
      the CVs were significant (P<0.001, for the left leg). Other parameters were not 
      different. CONCLUSIONS: If NMB is used during MEP monitoring, a target T(2)/Tc of 
      0.5 is recommended. In terms of the MEP amplitude and variability, no NMB was 
      more desirable than any level of partial NMB.
FAU - Kim, W H
AU  - Kim WH
AD  - Department of Anesthesiology and Pain Medicine, Samsung Medical Centre, 
      Sungkyunkwan University School of Medicine, 50, Irwon-Dong, Seoul 135-710, 
      Republic of Korea.
FAU - Lee, J J
AU  - Lee JJ
FAU - Lee, S M
AU  - Lee SM
FAU - Park, M N
AU  - Park MN
FAU - Park, S K
AU  - Park SK
FAU - Seo, D W
AU  - Seo DW
FAU - Chung, I S
AU  - Chung IS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20130201
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
RN  - 0 (Neuromuscular Nondepolarizing Agents)
RN  - 7E4PHP5N1D (Vecuronium Bromide)
SB  - IM
CIN - Br J Anaesth. 2013 Apr;110(4):497-500. PMID: 23508491
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anesthesia, General
MH  - Anesthesia, Intravenous
MH  - Arterial Pressure/drug effects
MH  - Electric Stimulation/*methods
MH  - Evoked Potentials, Motor/*physiology
MH  - Female
MH  - Functional Laterality/physiology
MH  - Heart Rate/drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Intraoperative/*methods
MH  - Movement
MH  - *Neuromuscular Blockade
MH  - Neuromuscular Nondepolarizing Agents
MH  - Neurosurgical Procedures/*methods
MH  - Sample Size
MH  - Treatment Outcome
MH  - Vecuronium Bromide
MH  - Young Adult
EDAT- 2013/02/05 06:00
MHDA- 2013/05/10 06:00
CRDT- 2013/02/05 06:00
PHST- 2013/02/05 06:00 [entrez]
PHST- 2013/02/05 06:00 [pubmed]
PHST- 2013/05/10 06:00 [medline]
AID - S0007-0912(17)32724-1 [pii]
AID - 10.1093/bja/aes395 [doi]
PST - ppublish
SO  - Br J Anaesth. 2013 Apr;110(4):567-76. doi: 10.1093/bja/aes395. Epub 2013 Feb 1.