Influence of serum concentrations of catecholamines and i.v. or volatile anaesthesia on evoked electromyography in the hand

Abstract

We have examined the correlation between serum concentrations of catecholamines and the evoked electromyographic (EEMG) response from the first dorsal interosseous muscle of the hand in 20 patients during minor surgery under propofol or enflurane anaesthesia without neuromuscular blocking drugs. The supinated forearm, with the wrist fully extended, was strapped firmly to an armboard and immobilized with adhesive tape. In the propofol group, the mean EEMG response to the first stimulus in the train-of-four (T1) decreased to 83.0% (95% confidence intervals (CI) 78.7-87.3%) of baseline, while in the enflurane group the mean EEMG T1 response decreased to 84.0% (95% CI 81.6-86.4%) of baseline. The decrease in the EEMG response occurred over 20 min and did not correlate with plasma concentrations of adrenaline or noradrenaline (correlation coefficients all < 0.26). We conclude that the decrease in EEMG response during the first 30 min of anaesthesia occurred during both i.v. and inhalation anaesthesia, and that changes in plasma concentrations of catecholamines did not cause the decrease in the EEMG response.

Effect of isoflurane and sevoflurane on the magnitude and time course of neuromuscular block produced by vecuronium, pancuronium and atracurium

“…Second, offset of neuromuscular block was measured using the evoked IE M G , which was shown to be unreliable in 5-42% (18% in the current study) of patients [29]. As advancing age is associated with a greater incidence of slow recovery after vecuronium [5], and because the IE M G is unreliable during offset of non-depolarizing neuro muscular block [30], considerable between-patient variability in duration of neuromuscular block may have been produced within the populations studied. In the investigation of Saitoh, Toyooka and Amaha [2], the scatter in the duration of neuromuscular block, after the same dose of vecuronium (0.2 mg kg-1) was so large that significant differences in the duration of neurom uscular block with opioidnitrous oxide and opioid-nitrous oxide-isoflurane (end-tidal isoflurane concentration = 1.15%) anaes thesia could not be demonstrated.…”