EFFECT OF SURFACE ELECTRODE POSITION ON THE COMPOUND ACTION POTENTIAL EVOKED BY ULNAR NERVE STIMULATION DURING ISOFLURANE ANAESTHESIA

The effect of surface electrode positioning on the evoked compound action potential was studied during isoflurane anaesthesia without neuromuscular block. In 20 ASA I–II patients (age 36–50 yr), the response after supramaximal ulnar nerve stimulation was analysed with a neuromuscular relaxation moni...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 1990-10, Vol.65 (4), p.494-499
Main Author: KALLI, I.
Format: Article
Language:English
Subjects:
Anesthesia, Inhalation
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Electric Stimulation
electrode position
Electrodes
Electromyography - instrumentation
Evoked Potentials - physiology
Hand - physiology
Humans
Isoflurane
Measurement techniques: neuromuscular junction
Medical sciences
Middle Aged
Neuromuscular transmission: action potentials
Neuropharmacology
Pharmacology. Drug treatments
Ulnar Nerve - physiology
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Summary:The effect of surface electrode positioning on the evoked compound action potential was studied during isoflurane anaesthesia without neuromuscular block. In 20 ASA I–II patients (age 36–50 yr), the response after supramaximal ulnar nerve stimulation was analysed with a neuromuscular relaxation monitor (Relaxograph, Datex) and with a memory recorder. Seven pairs of surface recording electrodes were compared: (1) adductor pollicis muscle vs second finger; (2) adductor pollicis m. vs first finger; (3) first dorsal interosseus m. vs second finger; (4) adductor digiti minimi m. vs fifth finger; (5) adductor pollicis m. vs second dorsal metacarpal; (6) abductor digiti minimi m. vs fourth dorsal metacarpal; (7) thenar vs hypothenar. Steady biphasic response was recorded with electrode pairs 1–4. Marked variation and low amplitude existed at pairs 5–7. Peak-to-peak amplitude at pair 3 was the greatest (12.5 (SD 3.7) mV) compared with pair 4 (9.4 (SD 2.0) mV) and pair 1 (8.5 (SD 2.0) mV). A close correlation between the amplitudes and integrated areas was found. The first dorsal interosseus muscle response was optimal and the electrodes were simple to fix; this site may be recommended for clinical monitoring.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/65.4.494