Intramuscular versus surface electromyography of the diaphragm for determining neuromuscular blockade.

Abstract:

:We determined the neuromuscular blockade of 0.2 mg. kg(-1) mivacurium at the diaphragm by using two new methods of electromyographic (EMG) monitoring and compared it with acceleromyography of the orbicularis oculi (OO) and the corrugator supercilii (CS) muscle. After the induction of anesthesia in 15 patients undergoing gynecologic laparoscopic surgery, evoked EMG responses at the diaphragm were obtained by using skin electrodes at the back of the patient, placed lateral to T12/L1 or L1/L2, and a laparoscopically applied wire electrode inserted into the dorsolateral portion of the diaphragm. Acceleromyography at the right OO and the left CS was performed. The facial and phrenic nerves were stimulated transcutaneously (onset: every 10 s, offset: every 15 s, single twitch stimulation). Lag and onset time, peak effect, and clinical duration (time to reach 75% of control value and time to reach 90% of control value) were measured and the results were compared by using analysis of variance; P < 0.05 showed significant difference. Pearson's correlation test and the Bland-Altman test were used to compare the two diaphragmatic monitoring methods. Mean peak effects of >98% were reached at all sites. Onset times at diaphragm (skin, IM) were significantly (P < 0.005) shorter than at the CS or OO (100 +/- 14 s and 98 +/- 16 s vs 147 +/- 39 s, 185 +/- 38 s) without being statistically different between OO and CS. There was a good correlation of lag, onset time, time to reach 75% of control value, and time to reach 90% of control value (r = 0.8, 0.9, 0.8, and 0.75; P < 0.01) between the two diaphragmatic methods. Mean difference and limits of agreements are -2 +/- 15 s, 1 +/- 21 s, -1 +/- 2.3 min, and -2 +/- 3.4 min. We showed a shorter onset and clinical duration at the diaphragm in comparison with CS and OO. Two methods of EMG of the diaphragm correlated well and showed good comparability. The novel method of surface diaphragmatic EMG at the patient's back may be useful during routine clinical anesthesia.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Hemmerling TM,Schmidt J,Wolf T,Hanusa C,Siebzehnruebl E,Schmitt H

doi

10.1097/00000539-200101000-00021

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

106-11

issue

1

eissn

0003-2999

issn

1526-7598

journal_volume

92

pub_type

临床试验,杂志文章
  • Predictors of Delayed Postoperative Respiratory Depression Assessed from Naloxone Administration.

    abstract:BACKGROUND:The aim of this study was to identify patient and procedural characteristics associated with postoperative respiratory depression or sedation requiring naloxone intervention. METHODS:We identified patients who received naloxone to reverse opioid-induced respiratory depression or sedation within 48 hours aft...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000792

    authors: Weingarten TN,Herasevich V,McGlinch MC,Beatty NC,Christensen ED,Hannifan SK,Koenig AE,Klanke J,Zhu X,Gali B,Schroeder DR,Sprung J

    更新日期:2015-08-01 00:00:00

  • The effect of cisatracurium and rocuronium on lung function in anesthetized children.

    abstract:BACKGROUND:Neuromuscular blocking drugs have been implicated in intraoperative bronchoconstrictive episodes. We examined the effects of clinically relevant doses of cisatracurium and rocuronium on the lung mechanics of pediatric subjects. We hypothesized that cisatracurium and rocuronium would have bronchoconstrictive ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3182a6d191

    authors: Yang CI,Fine GF,Jooste EH,Mutich R,Walczak SA,Motoyama EK

    更新日期:2013-12-01 00:00:00

  • Polydatin Inhibits Mitochondrial Dysfunction in the Renal Tubular Epithelial Cells of a Rat Model of Sepsis-Induced Acute Kidney Injury.

    abstract:BACKGROUND:Mitochondrial injury is a major cause of sepsis-induced organ failure. Polydatin (PD), a natural polyphenol, demonstrates protective mitochondrial effects in neurons and arteriolar smooth muscle cells during severe shock. In this study, we investigated the effects of PD on renal tubular epithelial cell (RTEC...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000977

    authors: Gao Y,Zeng Z,Li T,Xu S,Wang X,Chen Z,Lin C

    更新日期:2015-11-01 00:00:00

  • Laryngeal mask airway or endotracheal tube for percutaneous dilatational tracheostomy: a comparison of visibility of intratracheal structures.

    abstract:PURPOSE:Some severe complications during percutaneous dilatational tracheostomy (PDT) may be related to poor visualization of tracheal structures. Subjectively, the bronchoscopical view obtained via a laryngeal mask airway (LMA) seems to be better than that obtained with an endotracheal tube (ETT). In this prospective,...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3181d27fb4

    authors: Linstedt U,Zenz M,Krull K,Häger D,Prengel AW

    更新日期:2010-04-01 00:00:00

  • Postoperative analgesia after spinal blockade in infants and children undergoing cardiac surgery.

    abstract::The aim of this prospective, randomized, controlled clinical trial was to define the opioid analgesic requirement after a remifentanil (REMI)-based anesthetic with spinal anesthetic blockade (SAB+REMI) or without (REMI) spinal blockade for open-heart surgery in children. We enrolled 45 patients who were candidates for...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000148698.84881.10

    authors: Hammer GB,Ramamoorthy C,Cao H,Williams GD,Boltz MG,Kamra K,Drover DR

    更新日期:2005-05-01 00:00:00

  • Effects of sufentanil on cerebral blood flow, cerebral blood flow velocity, and metabolism in dogs.

    abstract::The intracranial and systemic hemodynamic effects of sufentanil (20 micrograms/kg) were studied in 10 mongrel dogs. Baseline anesthesia was maintained with 0.7% end-tidal isoflurane and 50% nitrous oxide in oxygen. Catheters were inserted for blood pressure measurement, arterial and sagittal sinus blood sampling, radi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199102000-00006

    authors: Werner C,Hoffman WE,Baughman VL,Albrecht RF,Schulte J

    更新日期:1991-02-01 00:00:00

  • Time course of action and endotracheal intubating conditions of Org 9487, a new short-acting steroidal muscle relaxant; a comparison with succinylcholine.

    abstract::In a randomized study, we evaluated lag time (time from the end of injection of muscle relaxant until the first depression of the train-of-four response [TOF]), onset time (time from the end of injection of muscle relaxant until the maximum depression of the first twitch of the TOF [T1]), neuromuscular block, and endo...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199309000-00026

    authors: Wierda JM,van den Broek L,Proost JH,Verbaan BW,Hennis PJ

    更新日期:1993-09-01 00:00:00

  • Ultrasound-guided peripheral nerve stimulator placement in two soldiers with acute battlefield neuropathic pain.

    abstract::Acute peripheral neuropathic pain after combat-related polytrauma is a common occurrence in the United States military that is often refractory to current drugs and regional anesthesia. Both spinal cord and peripheral nerve stimulation are successfully used for chronic neuropathic pain states, but are not reported for...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e318247f6b2

    authors: Kent M,Upp J,Spevak C,Shannon C,Buckenmaier C 3rd

    更新日期:2012-04-01 00:00:00

  • Intraoperative patient-controlled analgesia: an alternative to physician administration during outpatient monitored anesthesia care.

    abstract::Outpatients undergoing minor diagnostic and therapeutic procedures associated with intermittent discomfort are frequently given bolus injections of intravenous opioid analgesics. In a group of 80 healthy women undergoing vaginal ovum pickup procedures, we evaluated patient-controlled administration of alfentanil using...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-199207000-00008

    authors: Zelcer J,White PF,Chester S,Paull JD,Molnar R

    更新日期:1992-07-01 00:00:00

  • Regional anesthesia in children.

    abstract::Regional anesthesia employing the spinal, epidural, or caudal approach was used to anesthetize 200 children, varying in age from 17 days to 15 years. Lidocaine in concentrations varying according to age was used. Ketamine (1 to 2 mg./kg.) was given in the majority of cases to ensure a quiet patient prior to block. No ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197505000-00034

    authors: Melman E,Penuelas JA,Marrufo J

    更新日期:1975-05-01 00:00:00

  • Ilioinguinal iliohypogastric nerve blocks--before or after cesarean delivery under spinal anesthesia?

    abstract::Preoperative local anesthetic blockade of somatosensory pathways involved with skin incision and other noxious perioperative stimuli may "preempt" or attenuate the postoperative pain response. Since the Pfannenstiel incision lies within the L1 dermatome, bilateral ilioinguinal, iliohypogastric nerve blocks (IINBs) sho...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199601000-00003

    authors: Huffnagle HJ,Norris MC,Leighton BL,Arkoosh VA

    更新日期:1996-01-01 00:00:00

  • Transdiscal lumbar sympathetic block: a new technique for a chemical sympathectomy.

    abstract:UNLABELLED:Genitofemoral neuritis, which occurs when the neurolytic solution spreads into the psoas muscle, is the most common complication after neurolytic lumbar sympathetic block. We developed a transdiscal approach for neurolytic lumbar sympathetic block to reduce the danger of genitofemoral neuritis by making a sy...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199712000-00024

    authors: Ohno K,Oshita S

    更新日期:1997-12-01 00:00:00

  • Holiday and weekend operating room on-call staffing requirements.

    abstract:BACKGROUND:Every facility that performs cases on holidays has in some way decided on its operating room (OR) and anesthesia staffing for holidays. Previous studies have not examined how best to calculate appropriate holiday staffing. METHODS:We analyzed weekend and holiday data from a university hospital. RESULTS:The...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000237176.10774.17

    authors: Dexter F,Epstein RH

    更新日期:2006-12-01 00:00:00

  • Population pharmacokinetics of dexmedetomidine in infants after open heart surgery.

    abstract:BACKGROUND:Dexmedetomidine is a highly selective alpha(2)-agonist with hypnotic, analgesic, and anxiolytic properties. In adults, it provides sedation while preserving respiratory function facilitating extubation. Only limited pharmacokinetic data are available for pediatric patients. The primary aim of this study was ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181d783c8

    authors: Su F,Nicolson SC,Gastonguay MR,Barrett JS,Adamson PC,Kang DS,Godinez RI,Zuppa AF

    更新日期:2010-05-01 00:00:00

  • Effect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine.

    abstract:BACKGROUND:Postoperative sore throat (POST) is a common complication after endotracheal intubation. We compared the effectiveness on POST of spraying the endotracheal tube (ETT) cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine. METHODS:Three hundred seventy-two patients were randomly allocated into...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3181d4854e

    authors: Hung NK,Wu CT,Chan SM,Lu CH,Huang YS,Yeh CC,Lee MS,Cherng CH

    更新日期:2010-10-01 00:00:00

  • Hydroxyethyl starch: the effect of molecular weight and degree of substitution on intravascular retention in vivo.

    abstract:BACKGROUND:Hydroxyethyl starch (HES) solution is characterized by its mean molecular weight (MW), concentration, and degree of substitution (DS). This character varies worldwide. METHODS:After binding fluorescein-isothiocyanate (FITC-HES), we evaluated the retention rate of three types of 6% HES in the A2 and V2 blood...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000275198.84094.ad

    authors: Hitosugi T,Saito T,Suzuki S,Kubota I,Shoda E,Shimizu T,Oi Y

    更新日期:2007-09-01 00:00:00

  • Splanchnic and renal sympathetic activity in relation to hemodynamics during isoflurane administration in pigs.

    abstract::The aim of the present study was to investigate the impact of isoflurane on regional neurogenic mechanisms in the control of vascular tone. Therefore, regional determinations of sympathetic activity and hemodynamics were made in chloralose-anesthetized swine before and during administration of 1.4% isoflurane. Sympath...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199501000-00023

    authors: Aneman A,Pontén J,Fändriks L,Eisenhofer G,Friberg P,Biber B

    更新日期:1995-01-01 00:00:00

  • Late presentation of esophageal injury after transesophageal echocardiography.

    abstract::Esophageal injury is a rare complication of intraoperative transesophageal echocardiography (TEE) associated with cardiac surgery. We report two cases of delayed presentation (2 and 6 days after surgery) of esophageal injury that were likely due to TEE. The differential diagnosis of postoperative pleural effusion or a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000120085.40108.24

    authors: MacGregor DA,Zvara DA,Treadway RM Jr,Ibdah JA,Maloney JD,Kon ND,Riley RD

    更新日期:2004-07-01 00:00:00

  • Effect of volatile anesthetics on vecuronium-induced neuromuscular blockade in children.

    abstract::We studied 60 children undergoing elective surgery to evaluate the effect of interactions between vecuronium and isoflurane or halothane on the potency and duration of neuromuscular blockade, as measured by electromyography. Vecuronium was first administered by a logarithm-based cumulative method (14, 22, 35, 56, 89 m...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199003000-00003

    authors: Pittet JF,Melis A,Rouge JC,Morel DR,Gemperle G,Tassonyi E

    更新日期:1990-03-01 00:00:00

  • Patient-controlled epidural analgesia after abdominal surgery: ropivacaine versus bupivacaine.

    abstract:UNLABELLED:In this randomized, double-blinded study we sought to assess the analgesic efficacy of ropivacaine and bupivacaine in combination with sufentanil and the efficacy of ropivacaine alone after major abdominal surgery. Sixty patients undergoing major abdominal surgery received standardized general anesthesia com...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200112000-00055

    authors: Pouzeratte Y,Delay JM,Brunat G,Boccara G,Vergne C,Jaber S,Fabre JM,Colson P,Mann C

    更新日期:2001-12-01 00:00:00

  • Educating Patients Regarding Pain Management and Safe Opioid Use After Surgery: A Narrative Review.

    abstract::In recent years, there have been escalating concerns related to the opioid epidemic. With a steadily increasing opioid supply, it is critical to provide proper education to patients who are prescribed these medications. Education should be emphasized as a means of ensuring safe use and potentially as a strategy for cu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000004436

    authors: Lee BH,Wu CL

    更新日期:2020-03-01 00:00:00

  • A randomized, double-blinded study of remifentanil versus fentanyl for tonsillectomy and adenoidectomy surgery in pediatric ambulatory surgical patients.

    abstract:UNLABELLED:We compared, in a double-blinded manner, the anesthetic maintenance and recovery properties of remifentanil with a clinically comparable fentanyl-based anesthetic technique in pediatric ambulatory surgical patients. Anesthesia was induced with either halothane or sevoflurane and nitrous oxide and oxygen. Pat...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00000539-200004000-00017

    authors: Davis PJ,Finkel JC,Orr RJ,Fazi L,Mulroy JJ,Woelfel SK,Hannallah RS,Lynn AM,Kurth CD,Moro M,Henson LG,Goodman DK,Decker MD

    更新日期:2000-04-01 00:00:00

  • A comparison of lidocaine and bupivacaine digital nerve blocks on noninvasive continuous hemoglobin monitoring in a randomized trial in volunteers.

    abstract:BACKGROUND:Blood hemoglobin can be monitored continuously and noninvasively with a noninvasive spectrophotometric sensor (Masimo SpHb). The perfusion index (PI) of the finger is directly related to the clinical accuracy of SpHb. We evaluated those variables that influence PI without the influences of surgery and anesth...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000000144

    authors: Miller RD,Ward TA,McCulloch CE,Cohen NH

    更新日期:2014-04-01 00:00:00

  • Immediate tracheal extubation after liver transplantation: experience of two transplant centers.

    abstract::Early tracheal extubation has been safely performed after large operative procedures, questioning the need for routine postoperative ventilation. Because immediate postoperative tracheal extubation of liver transplantation patients has not been previously reported, we performed preliminary studies at two institutions ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199702000-00003

    authors: Mandell MS,Lockrem J,Kelley SD

    更新日期:1997-02-01 00:00:00

  • A survey of anesthesiologists' views of operating room recycling.

    abstract:BACKGROUND:Operating rooms contribute significantly to the increasing volumes and costs of hospital waste. Little is known, however, about doctors' views of hospital waste recycling despite their potential influence in improving recycling programs. We surveyed the waste recycling views held by anesthesiologists in Aust...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e31824d273d

    authors: McGain F,White S,Mossenson S,Kayak E,Story D

    更新日期:2012-05-01 00:00:00

  • Volatile anesthetic requirements differ in mice selectively bred for sensitivity or resistance to diazepam: implications for the site of anesthesia.

    abstract::One approach to elucidating the general anesthetic target has used genetic selection procedures, wherein animals are bred for sensitivity or resistance to general anesthetics and correlations are sought with a specific neuronal structural or functional defect. For example, murine strains have been developed that are e...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199376060-00022

    authors: McCrae AF,Gallaher EJ,Winter PM,Firestone LL

    更新日期:1993-06-01 00:00:00

  • Forearm compartment syndrome from intravenous mannitol extravasation during general anesthesia.

    abstract:IMPLICATIONS:Complications of IV mannitol administration resulting in compartment syndrome may warrant surgical intervention. Compartment syndrome is difficult to diagnose in the anesthetized patient. Infusing mannitol in an observed IV site permits discontinuation of mannitol before complications ensue. Early recognit...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200301000-00049

    authors: Edwards JJ,Samuels D,Fu ES

    更新日期:2003-01-01 00:00:00

  • An ultrasound evaluation of laryngeal mask airway position in pediatric patients: an observational study.

    abstract:BACKGROUND:In children, the laryngeal mask airway (LMA) is frequently displaced within the hypopharynx, resulting in repositioning of the device. When the tip of the LMA is placed in the esophageal inlet, the arytenoids are moved ventrally. When the LMA is rotated or deviated, the ventral movement of the arytenoids may...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000551

    authors: Kim J,Kim JY,Kim WO,Kil HK

    更新日期:2015-02-01 00:00:00

  • Designing meaningful industry metrics for clinical productivity for anesthesiology departments.

    abstract:IMPLICATIONS:Clinical productivity measurements that account for differences in clinical settings and concurrencies provided more precise comparisons between two anesthesiology groups. The data show that different concurrencies confound the current industry standard, "per full-time equivalent" measurements, whereas "pe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200108000-00014

    authors: Abouleish AE,Prough DS,Zornow MH,Lockhart A,Abate JJ,Hughes J

    更新日期:2001-08-01 00:00:00

  • A controlled study of transesophageal echocardiography to guide central venous catheter placement in congenital heart surgery patients.

    abstract:UNLABELLED:Transesophageal echocardiography (TEE) and central venous catheter (CVC) placement are often used during congenital cardiac surgery. Complications of CVC placement include cardiac perforation, inadvertent arterial placement, and erroneous hemodynamic data from unrecognized malposition. In this study, we used...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199907000-00012

    authors: Andropoulos DB,Stayer SA,Bent ST,Campos CJ,Bezold LI,Alvarez M,Fraser CD

    更新日期:1999-07-01 00:00:00