Feasibility of electromyography (sEMG) in measuring muscular activity during spinal anaesthesia in patients undergoing knee arthroplasty

Background:  Bromage scale (0–3) is used to measure the degree of motor block during spinal anaesthesia. However, an estimation of motor block is difficult during surgery. The purpose of this study was to evaluate the feasibility of surface EMG describing spontaneous muscular activity in the lower e...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2005-04, Vol.49 (4), p.558-562
Main Authors: Niemi-Murola, L., Paloheimo, M.
Format: Article
Language:English
Subjects:
Adult
Aged
Ambulatory Surgical Procedures
Anesthesia, Spinal
Arthroplasty, Replacement, Knee
Bupivacaine
Double-Blind Method
Electromyography - methods
EMG
Feasibility Studies
Female
Humans
Male
Middle Aged
Monitoring, Intraoperative - methods
motor block
Muscle, Skeletal - physiology
spinal anaesthesia
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Summary:Background:  Bromage scale (0–3) is used to measure the degree of motor block during spinal anaesthesia. However, an estimation of motor block is difficult during surgery. The purpose of this study was to evaluate the feasibility of surface EMG describing spontaneous muscular activity in the lower extremities during spinal anaesthesia. Methods:  In part I of the study, 13 patients undergoing day case surgery were studied. They received 10 mg hyperbaric bupivacaine at interspace L3–4. EMG, sensory and muscular block were measured at 5‐min intervals during the first 30 min and then every 15 min until the patient was able to flex the knee. In part II of the study, 16 patients undergoing knee arthroplasty received 10 mg bupivacaine through spinal catheter at interspace L3–4 (Group CSA). An additional bolus of 2.5 mg was administered using EMG‐guidance, if needed. Another group, 15 patients, received a single bolus of bupivacaine (15–20 mg) at L3–4 (Group Bolus). EMG, muscular and sensory block were monitored as described above. The epidural catheter was used as rescue. Results:  Part I: EMG compared to modified Bromage scale showed a significant correlation (P 
ISSN:0001-5172
1399-6576
DOI:10.1111/j.1399-6576.2005.00603.x