Facial Nerve Monitoring under Different Levels of Neuromuscular Blockade with Cisatracurium Besilate in Parotid Tumour Surgery.

Background. Anaesthesia can alter neuronal excitability and vascular reactivity and ultimately lead to neurovascular coupling. Precise control of the skeletal muscle relaxant doses is the key in reducing anaesthetic damage. Methods. A total of 102 patients with the normal functioning preoperative fa...

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Publicado en:BioMed Research International pp. 1 - 12
Autores principales: Huang, Huimin, Jiang, Hong, Liu, Jinxing, Chen, Jie, Qiu, Lin, Wang, Jiayi, Liu, Wenhui, Chen, Huan
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell 7/17/2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 7/17/2021
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1155/2021/5655061
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        atl: Facial Nerve Monitoring under Different Levels of Neuromuscular Blockade with Cisatracurium Besilate in Parotid Tumour Surgery.
      aug:
        au:
          Huang, Huimin
          Jiang, Hong
          Liu, Jinxing
          Chen, Jie
          Qiu, Lin
          Wang, Jiayi
          Liu, Wenhui
          Chen, Huan
        affil: Department of Anesthesiology, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
      sug:
        subj:
          Facial Nerve Physiology
          Intraoperative Monitoring
          Neuromuscular Blockade Methods
          Neuromuscular Nondepolarizing Agents Administration and Dosage
          Parotid Neoplasms Surgery
          Human
          Anesthetics Adverse Effects
          Adverse Drug Event Prevention and Control
          Cancer Patients
          Preoperative Period
          Descriptive Statistics
          Muscle Relaxation Evaluation
          Electromyography
          Movement
          Respiration, Artificial
          Decision Trees
          Models, Statistical
          Prediction Models
          Body Mass Index
          Anesthesia, Intravenous
          Anesthetics, General Administration and Dosage
      ab: Background. Anaesthesia can alter neuronal excitability and vascular reactivity and ultimately lead to neurovascular coupling. Precise control of the skeletal muscle relaxant doses is the key in reducing anaesthetic damage. Methods. A total of 102 patients with the normal functioning preoperative facial nerve who required parotid tumour resection were included in this study. Facial nerve monitoring was conducted intraoperatively. The surgeon stimulated the facial nerve at different myorelaxation intervals at TOF% (T4/T1) and T1% (T1/T0) and recorded the responses and the amplitude of electromyogram (EMG). Body movements (BM) or patient-ventilator asynchrony (PVA) was recorded intraoperatively. Results. In parotid tumour resection, T1% should be maintained at a range of 30 to 60% while TOF% should be maintained at a range of 20 to 30%. Analysis of the decision tree model for facial nerve monitoring suggests a partial muscle relaxation level of 30 % < T 1 % ≤ 50 % and TOF ≤ 60 %. A nomogram prediction model, while incorporating factors such as sex, age, BMI, TOF%, and T1%, was constructed to predict the risk of BM/PVA during surgery, showing good predictive performance. Conclusions. This study revealed an adequate level of neuromuscular blockade in intraoperative parotid tumour resection while conducting facial nerve monitoring. A visual nomogram prediction model was constructed to guide anaesthetists in improving the anaesthetic plan.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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