The Effect Of Muscle Relaxant On Electrophysiological Monitoring And Endotracheal Intubation In Microvascular Decompression

Objective : The effect of different kinds of muscle relaxants and without musce relaxant in anesthesia induction on intraoperative neurophysiological monitoring represented by lateral spread response and endotracheal intubation during microvascular decompression for hemifacial spasm was investigated.Metnod:60 patients with hemifacial spasm from October 2015 to September 2017 were selected from Department of Neurosurgery,the First Affiliated Hospital of Shihezi University Medical College and randomly divided into three groups,twenty cases in each group.All patients monitored the lateral spread response and other neurophysiological monitoring during the operation.During anesthesia induction,depolarizing muscle relaxants such as succinylcholine(1.5mg/kg,Group A)and non depolarizing muscle relaxants such as cisatracurium besylate(0.2mg/kg,Group B)and no muscle relaxant(Normal saline 10 ml,Group C),were used for induction.Observe records of patients’ tracheal intubation conditions,hemodynamic changes during intubation and the time of the first stimulation of the lateral spread response.Results :In terms of hemodynamics during anesthesia induction,there was no significant difference in mean arterial pressure and heart rate between three groups at 2 minutes after radial artery puncture,before tracheal intubation,1 minute after endotracheal intubation and 3 minutes after endotracheal intubation(P >0.05).In terms of intubation conditions,the excellent rate of succinylcholine group was 100%,and cisatracurium group was 95%(19/20),and excellent rate without the use of muscle relaxant group was 90%(18/20).The difference between three groups had no obvious statistical significance(P > 0.05).In terms of effects on muscle relaxant on neural electrophysiological monitoring,at the beginning of operation,to stimulate the lateral spread response of succinylcholine group and without the use of muscle relaxant group success rate was 100%(20/20),cisatracurium group success rate was 75%(15/20).The difference was statistically significant(P < 0.05).When the dura was opened,the success rate of the B group was increased to 100%,and the difference was not statistically significant(P > 0.05).Conclusion:In the induction of microvascular decompression for hemifacial spasm,the use of depolarizing muscle relaxant and no muscle relaxant had no significant effect on the stimulation of lateral spread response and conditions of tracheal intubation.The use of non depolarizing muscle relaxants cisatracurium will make the lateral spread response stimulus waveform extraction time increase,but the extension does not affect the operation of the monitoring requirements.