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首页> 外文期刊>Veterinary Anaesthesia and Analgesia >Comparison between acceleromyography and visual assessment of train-of-four for monitoring neuromuscular blockade in horses undergoing surgery
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Comparison between acceleromyography and visual assessment of train-of-four for monitoring neuromuscular blockade in horses undergoing surgery

机译：加速肌电图和视觉评估四联训练监测手术马匹神经肌肉阻滞的比较

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To compare acceleromyography (AMG) with visual assessment of train-of-four (TOF) for monitoring neuromuscular blockade and detecting residual muscle paralysis in horses receiving atracurium. Prospective, controlled clinical study. Nine adult, client-owned horses weighing 577 (436, 727) kg (median, minimum, maximum) and ASA physical status I-II, admitted for surgery. An electrical nerve stimulator was used to stimulate the peroneal nerve with TOFs at 1 minute intervals. Before and after atracurium administration (0.15 mg kgp#, IV), the number of twitches observed (TOF count, or TOFc) was assessed visually. When four twitches were seen (i.e., TOFc = 4) presence or absence of fade by visual assessment was recorded. Simultaneously, the response to each TOF was assessed by AMG; this measured TOFc, and twitch fade using TOF ratio (TOFR; ratio of fourth to first twitch). The anesthetist performing the visual evaluation was blinded to the AMG readings. Recovery from neuromuscular blockade was defined as the absence of fade by visual inspection or a TOFR >=90% by AMG. During onset of action of the drug, fade was first detected 4 (1, 8) minutes earlier by AMG (p = 0.008). Maximal blockade started at 6 (3, 17) minutes by visual assessment and 9 (3, 25) minutes by AMG (not significantly different). Only four horses achieved complete neuromuscular blockade (TOFc of zero by both methods); in those four horses AMG did not detect the start of the return of neuromuscular transmission before visual assessment. Visual assessment indicated the return of four twitches with no fade 12 (8, 42) minutes before AMG gave a TOFR of >=90% (p = 0.004). There was no substantial advantage for AMG in detecting the onset of atracurium-induced neuromuscular blockade. However, AMG detected residual blockade when visual assessment of TOF did not. Application of AMG is likely to reduce the incidence of residual blockade.
机译：为了比较加速肌电图（AMG）与四轮训练（TOF）的视觉评估，以监测神经肌肉阻滞和检测接受阿曲库铵的马中残留的肌肉麻痹。前瞻性对照临床研究。接受手术的九头成年，客户所有的马匹，体重577（436，727）kg（中值，最小，最大）和ASA身体状况I-II。用电神经刺激器以1分钟的间隔用TOF刺激腓神经。在给予阿曲库铵之前和之后（0.15 mg kgp＃，静脉注射），目测观察到的抽搐次数（TOF计数或TOFc）。当看到四次抽搐（即，TOFc ＝ 4）时，通过视觉评估记录是否存在褪色。同时，AMG对每个TOF的反应进行了评估;测得的TOFc，并使用TOF比率（TOFR;第四次与第一次抽动的比率）抽动衰落。进行视觉评估的麻醉师对AMG的读数不了解。从神经肌肉阻滞恢复中定义为通过目测检查不出现褪色或AMG的TOFR> = 90％。在药物起效期间，AMG首先在4（1、8）分钟之前检测到褪色（p = 0.008）。通过视觉评估在6（3，17）分钟开始最大阻断，而通过AMG在9（3，25）分钟开始最大阻断（无显着差异）。只有四匹马实现了完全的神经肌肉阻滞（两种方法的TOFc均为零）。在这四匹马中，AMG在进行视觉评估之前没有检测到神经肌肉传递恢复的开始。视觉评估表明，在AMG的TOFR≥90％之前，在12（8，42）分钟内恢复了四次抽动，没有褪色（p = 0.004）。 AMG在检测阿曲库铵诱导的神经肌肉阻滞发作方面没有实质性优势。但是，AMG在未对TOF进行目测评估时检测到残留的堵塞。使用AMG可能会减少残留阻塞的发生率。

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