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Abstract：
BACKGROUND Mivacurium is a non-depolarizing neuromuscular blocking agent. TOF-Cuff® is a device that monitors intraoperative neuromuscular blockade and blood pressure. TOF-Scan® measures muscle relaxation status of an anaesthetized patient. This study included 36 patients aged 18 to 75 years presenting for elective surgery, to compare neuromuscular blockade measured using the TOF-Cuff of the upper arm and the TOF-Scan of the facial corrugator supercilii muscle during general anesthesia and following administration of mivacurium. MATERIAL AND METHODS Train-of-four (TOF) values were obtained every 30 s before intubation and successively every 5 min until extubation. RESULTS The median onset time for TOF-Cuff was longer than for TOF-Scan (210 s vs 90 s, P<0.00001). Multiplying the time to relaxation (according to TOF-Scan) by 1 to 8, respectively, provided concordance with the TOF-Cuff result for the following cumulative percentages of patients: 5.5%, 38.9%, 58.3%, 77.8%, 83.3%, 86.1%, 88.9%, and 91.7%. Analogue values for time to recovery from the last dose were 11.1%, 63.9%, 83.3%, 86.1%, 86.1%, 88.9%, 88.9%, and 91.7%. The proportion of patients who still had TOFratio=0 in the assessment performed at min 15 did not differ significantly between these 2 methods (P=0.088). Both TOF-Scan and TOF-Cuff showed a false-negative result in patients with clinical symptoms of preterm recovery; the numerical difference favored TOF-Cuff (1.6% vs 2.1%) but without statistical significance (P=0.2235). CONCLUSIONS When measurement on the limb is not possible, TOF-Scan on the eyelid can be an alternative for TOF-Cuff on the upper arm, if the time to relaxation is multiplied by at least 8, which is enough for 90% of patients.
摘要：
背景技术米伐库铵是一种非去极化神经肌肉阻断剂。TOF-Cuff®是一种监测术中神经肌肉阻滞和血压的设备。TOF-Scan®测量麻醉患者的肌肉松弛状态。这项研究包括36名年龄在18至75岁之间的择期手术患者，比较在全身麻醉期间和施用米伐库铵后，使用上臂的TOF-Cuff测量的神经肌肉阻滞和面部皱褶上肌的TOF-Scan测量的神经肌肉阻滞。材料和方法插管前每30s获得一次四组（TOF）值，然后每5分钟获得一次直到拔管。结果TOF-Cuff的中位起效时间长于TOF-Scan（210svs90s，P<0.00001)。将弛豫时间（根据TOF-Scan）分别乘以1到8，为以下累积百分比的患者提供与TOF-Cuff结果的一致性：5.5%，38.9%,58.3%,77.8%,83.3%,86.1%,88.9%,91.7%。从最后一次剂量恢复时间的模拟值为11.1％，63.9%,83.3%,86.1%,86.1%,88.9%,88.9%,91.7%。在第15分钟进行的评估中，TOFratio=0的患者比例在这两种方法之间没有显着差异（P=0.088）。TOF-Scan和TOF-Cuff在有早产恢复临床症状的患者中均显示假阴性结果；数值差异有利于TOF-Cuff（1.6％vs2.1％），但无统计学意义（P=0.2235）。结论当无法对肢体进行测量时，眼睑上的TOF扫描可以替代上臂上的TOF手铐，如果放松时间乘以至少8，这对于90％的患者来说是足够的。
