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KMID : 0356919920250040755
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Korean Journal of Anesthesiology
1992 Volume.25 No. 4 p.755 ~ p.759
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The Isolation Arm Test for the Assessment of Neuromuscular Blockade: Reevaluation of Injection SIte Influencing to the Twitch Responses
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김성열
황경호/김선종/박운/안기량/김천숙
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Abstract
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The isolation arm test ar upper limb for the study of muscle relaxants sensitivity of humar muscle is described. In the healthy adults. Succinylcholine 100ug kg or vecuronium 5~6ug kg combined with 20ml saline is given intravenously at various
sites of
injection while the circulation to the arm is occluded with upper arm pneumatic tournique. After inejction of muscle relaxants. Neuromuscular transmission is then studied by TOF stimulation to ulnar nerve with EMG monitor(ABM, Datex) and changes
of
twitch response in evoked muscle action potential amplitude from hypothenar muscle are recorded.
In the results, twitch height is depressed weakly and slowly but incompletely after muscle relaxant is injected intravenously at cubital fossa. And declines declines further depression following recovery after the release of upper arm tourniquet
occluded systemic circulation(two stage response). Tnere are not any changes of twitch response while muscle relaxants are give intravenously between upper arm and forearm pneumatic tourniquet. But twitch height is depressed rapidely and
completely
after muscle relaxants are given intravenously at doris hand under the upper arm or forearm pneumatic tourniquet.
Conclusively, twitch response under the isolation arm test is influenced from the site of injection, and in order to obtain the correct assessment of neuromuscular blockade. Muscle relaxants will be give intravenously at dorsi hand with forearm
pneumatic tourniquet.
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