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Nondepolarizing neuromuscular blockade does not alter sensory evoked potentials
1Department of Anesthesiology, University of Texas Health Science Center at San Antonio 78284-7838.
Journal of Clinical Monitoring
|January 1, 1994
Summary
Changes in nondepolarizing neuromuscular blockade (NMB) did not significantly alter evoked potentials like brain stem auditory or visual evoked potentials. This suggests NMB may have minimal impact on intraoperative monitoring of these specific neurophysiologic signals.
Area of Science:
- Neuroscience
- Anesthesiology
- Clinical Neurophysiology
Background:
- Intraoperative monitoring relies on evoked potentials to assess neural pathway integrity.
- Nondepolarizing neuromuscular blockade (NMB) is frequently used during surgery, potentially affecting neurophysiologic measurements.
Purpose of the Study:
- To investigate the impact of varying degrees of NMB on the latency and amplitude of specific evoked potentials.
- To determine if NMB influences brain stem auditory evoked potentials (BAEPs), visual evoked potentials (VEPs), and median nerve somatosensory evoked potentials (MNSEPs).
Main Methods:
- Ten cynomolgus monkeys underwent ketamine anesthesia with incrementally adjusted NMB using vecuronium or atracurium.
- NMB was quantified via mechanical hand muscle response and electromyographic activity.
- Latencies and amplitudes of BAEPs, VEPs, spinal cord responses, and MNSEPs were measured.
Main Results:
- No statistically significant changes in latency or amplitude were observed for any measured evoked potential variable across different NMB levels.
- Evoked potential measurements remained consistent when compared to the unblocked control state.
Conclusions:
- Fluctuating levels of nondepolarizing neuromuscular blockade appear to have minimal influence on the measured evoked potentials under the tested conditions.
- These findings suggest NMB may contribute little to variability in intraoperative evoked potential monitoring.