复合运动作用电位的曲线下的面积和振幅是神经肌肉阻断的临床可互换的定量度量:一种方法比较研究
Richard H Epstein1, Réka Nemes2, Johnathan R Renew3
1Department of Anesthesiology, Perioperative Medicine & Pain Management, University of Miami, Miller School of Medicine, Miami, FL, USA.
BJA open
|July 8, 2024
概括
对于神经肌肉块深度的表面电肌图 (EMG) 监视器是可互换的,无论是使用复合运动作用电位 (cMAP) 幅度还是曲线下的面积 (AUC). 这一发现确保了对神经肌肉阻塞深度的一致的临床解释,无论具体的EMG测量方法如何.
科学领域:
- 麻醉学和重症监护医学.
- 临床神经生理学.
- 药学动力学和药物监测.
背景情况:
- 目前的指导方针主张进行定量神经肌肉阻断监测.
- 表面电肌图 (EMG) 是一个关键技术,可以测量复合运动作用电位 (cMAP) 幅度或曲线下面积 (AUC).
- 关于这些EMG测量方法的可互换性,缺乏严格的评估.
研究的目的:
- 评估cMAP振幅与AUC的可互换性,以量化神经肌肉阻塞深度.
- 确保神经肌肉块深度的EMG解释不受所选择的测量方法的影响.
主要方法:
- 来自48名接受罗库的患者的数字化EMG波形的分析.
- 从有效的cMAP中对对计算EMG振幅和AUC.
- 使用重复测量的T1/T1c和TOFR的比较. 布兰德-阿尔特曼分析.
主要成果:
- 对于T1/T1c (林氏CCC=0.98) 和TOFR (林氏CCC=0.995) 的cMAP振幅和AUC方法之间具有很高的一致性.
- 在T1/T1c和TOFR比较中观察到最小偏差和高重复系数 (<0.08).
- 很少有差异超出预规定的临床协议范围,表明可互换性.
结论:
- 定量神经肌肉阻塞深度评估在临床上可以使用cMAP振幅或AUC进行互换.
- 这些发现支持EMG监测的一致应用,无论具体的参数计算如何.
- 这证实了基于EMG的神经肌肉阻断监测在临床实践中的可靠性.
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