Overview

Paraspinal Muscle Relaxation in Spine Surgery

Status:
Completed
Trial end date:
2018-12-21
Target enrollment:
0
Participant gender:
All
Summary
During anesthesia, neuromuscular blocking agents (NMBA) are routinely used for relaxation of muscles necessary for the conduction of the surgical procedure. Train-of-four (TOF) test is based on supramaximal stimulation of peripheral nerve resulting in four twitches: T1 to T4. The assessment of the NMBA blockade is performed routinely by measurement of the amplitude of compound muscle action potential (CMAP) and calculation of percentage of CMAP decrement from T1 to T4. Train-of-four monitoring is routinely performed during spine surgery by stimulation of the ulnar nerve. Furthermore motor evoked potentials (MEPs) are routinely used in intraoperative neuromonitoring to assess the whole motor pathway from the cortical level down to the distal muscle. During anesthesia MEPs are routinely evoked by transcranial electrical stimulation with single or short train stimuli. In clinical practice even though full muscle relaxation of the hand by NMBA can be observed, utilizing the TOF test, remaining muscle tonus can be observed at the paraspinal musculature during spine surgery. The goals of this study are to determine (1) if any differences between muscle relaxation of the hand and foot (measured by TOF test and MEPs) and MEPs of the paraspinal musculature occur; (2) how much more NMBA must be administered to achieve full muscle relaxation of the paraspinal musculature in comparison to the hand or foot.
Phase:
N/A
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Balgrist University Hospital
Treatments:
Anesthetics
Neuromuscular Blocking Agents
Rocuronium
Criteria
Inclusion Criteria:

- All patients that will undergo spinal surgery with intraoperative neurophysiological
Monitoring

- Age: 14 - 99 years

Exclusion Criteria:

- No intraoperative neurophysiological Monitoring

- Age <14 year

- prior neurological diseases or deficits that may affect safety of
surgery/Intraoperative neuromonitoring

- No informed consent