Überwachung der neuromuskulären Funktion: Kapnographie versus Relaxometrie
| Autor: | G. Lenz, T. Albrecht, U. Bissinger, R. Schorer, A. Reiter |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Capnography
medicine.diagnostic_test business.industry Neuromuscular transmission General Medicine Critical Care and Intensive Care Medicine Adductor pollicis muscle Diaphragm (structural system) Peripheral Curare Anesthesiology and Pain Medicine Isoflurane Anesthesia Emergency Medicine medicine Breathing business medicine.drug |
| Zdroj: | AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie. 28:359-362 |
| ISSN: | 1439-1074 0939-2661 |
| DOI: | 10.1055/s-2007-998940 |
| Popis: | OBJECTIVE A notch ("curare cleft") in the plateau phase of the capnogram of the ventilated patient has been presumed to be a typical early sign of the fading effect of muscle relaxants on the diaphragm. For that reason a prospective study was done to investigate whether capnography can be used diagnostically to indicate the fading effect of vecuronium confirmed by peripheral relaxometry. METHODS Twenty-five consecutive patients who received inhalation anaesthesia with isoflurane, N2O/O2, and vecuronium during elective neurosurgical procedures were studied. Whenever intraoperative "curare clefts" appeared in the capnogram, diaphragm activity was measured and a simultaneous relaxogram of the adductor pollicis muscle was recorded. After every such event, vecuronium was readministered for complete relaxation. RESULTS A deformation of the capnogram was registered in 17/25 patients and in all instances (51/51) was caused by diaphragm activity. The deformation disappeared after renewed relaxation and was therefore a reliable indicator of spontaneous breathing. However, it did not correlate with the degree of relaxation of peripheral muscles, because diaphragm activity was present during all degrees of peripheral relaxation, but could also be absent even after complete recovery of neuromuscular transmission. CONCLUSION Capnography is therefore not a reliable method to indicate the fading effect of muscle relaxants. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|