ELECTROMYOGRAPHIC FACIAL-NERVE MONITORING DURING RESECTION FOR ACOUSTIC NEURINOMA UNDER MODERATE TO PROFOUND LEVELS OF PERIPHERAL NEUROMUSCULAR BLOCKADE
M. Brauer et al., ELECTROMYOGRAPHIC FACIAL-NERVE MONITORING DURING RESECTION FOR ACOUSTIC NEURINOMA UNDER MODERATE TO PROFOUND LEVELS OF PERIPHERAL NEUROMUSCULAR BLOCKADE, European journal of anaesthesiology, 13(6), 1996, pp. 612-615
The facial nerve is monitored intra-operatively using electromyography
to identify:and prevent damage during the excision of an acoustic neu
rinoma. In order to determine whether a profound level of peripheral n
euromuscular blockade could be achieved without compromising facial el
ectromyographic monitoring, 11 patients undergoing resection of acoust
ic neuroinoma were studied. After induction of anaesthesia, an infusio
n of atracurium was administered to reduce the integrated electrically
evoked muscle potential (EEMP) of the hypothenar eminence by 70-100%.
The facial nerve was directly stimulated in the surgical field and th
e facial evoked muscle potentials (EMPs) we re recorded. Even under co
mplete peripheral neuromuscular blockade (i.e. no electrically evoked
muscle potential measurable over the hypothenar eminence, no palpable
hypothenar muscle response) it was possible to evoke facial muscle ele
ctromyographic responses by stimulation of the facial nerve.