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Related Experiment Videos

Quantitative surface electromyography in anesthesia and critical care.

H L Edmonds, L J Couture, S L Stolzy

    International Journal of Clinical Monitoring and Computing
    |January 1, 1986
    PubMed
    Summary

    Spontaneous electromyography (SEMG) can monitor patient comfort during surgery and detect brainstem function in comatose patients. SEMG changes reflect pain, opiate effects, and intracranial pressure, offering objective physiological measures.

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    Area of Science:

    • Anesthesiology
    • Neurophysiology
    • Critical Care Medicine

    Background:

    • The frontalis muscle's spontaneous electromyogram (SEMG) and evoked electromyogram (EEMG) are valuable physiological indicators.
    • Understanding SEMG responses in various clinical states is crucial for patient monitoring.

    Purpose of the Study:

    • To investigate the utility of SEMG and EEMG in assessing patient responses to stimuli under anesthesia and in comatose states.
    • To explore SEMG as an indicator of analgesia adequacy, opiate effects, and brainstem function.

    Main Methods:

    • Recorded SEMG and EEMG from the frontalis muscle in diverse clinical settings, including anesthetized and comatose patients.
    • Applied surgical, acoustic, and electrical stimuli, and administered neuromuscular blockers and opiate analgesics.

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  • Correlated SEMG changes with intracranial pressure (ICP) in head-injured patients.

    • Main Results:

    • In conscious patients, SEMG amplitude increased with painful stimuli, indicating potential inadequate analgesia.
    • Opiate analgesics consistently decreased SEMG amplitude in conscious patients, offering a quantifiable measure of central opiate effect.
    • In comatose patients, SEMG amplitude could increase in response to elevated ICP or auditory stimuli, suggesting preserved brainstem function.

    Conclusions:

    • SEMG provides an objective measure of pain and stress, useful for intra-operative and post-operative analgesia monitoring.
    • SEMG can serve as a sensitive indicator of central opiate effects.
    • Auditory and stress-evoked SEMGs offer insights into brainstem function independent of consciousness level in critically ill patients.