Effect of partial neuromuscular blockade on efficacy and safety of nerve monitoring during microvascular decompression of facial nerve

Abstract

Objective To evaluate the effect of partial neuromuscular blockade (NMB) on the efficacy and safety of nerve monitoring during microvascular decompression (MVD) of facial nerve. Methods Seventy American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 39-78 yr, weighing 44-84 kg, scheduled for elective MVD, were divided into 2 groups (n=35 each) using a random number table method: control group and partial NMB group.Anesthesia was induced by intravenous injection of 3-fold ED95 cisatracurium.In control group, muscle relaxants were not used after intubation.In partial NMB group, cisatracurium was continuously infused intravenously to maintain partial NMB, and the T1/Tc ratio was maintained at 20%-40%.Intraoperative neuroelectrophysiological monitoring was performed using lateral spread response (LSR). The success rates of LSR monitoring, occurrence of body movement, requirement for anesthetics and cardiovascular agents were recorded during operation, and the patients were followed up on day 7 after surgery, and the therapeutic efficacy and occurrence of neurological complications were recorded. Results Compared with control group, the incidence of intraoperative body movement was significantly decreased, the intraoperative consumption of propofol and remifentanil was decreased, and the intraoperative requirement for vasopressors was decreased in partial NMB group (P 0.05). Conclusion Partial NMB (T1/Tc=20%-40%) can be effectively used for MVD monitored by LSR, decrease the occurrence of the body movement, and raise the perioperative safety in patients. Key words: Muscle relaxation; Facial nerve; Microvascular decompression surgery; Monitoring, intraoperative