部分神经肌肉阻滞在神经电生理监测中的应用

Partial neuromuscular blockade use during intraoperative neurophysiologic monitoring

背景在术中神经电生理监测（intraoperative neurophysiologic monitoring，IONM）中，肌肉松弛药（肌松药）由于影响神经肌肉接头兴奋的传递而限制使用。目的系统综述部分神经肌肉阻滞（partial neuromuscular blockade，pNMB）对神经电生理监测的影响，详细阐述肌松药在IONM中的应用。内容将近年来关于肌松药对IONM的影响及pNMB下的神经电生理监测的文献进行详细整理、系统综述。趋向pNMB能为IONM提供良好的监测条件，提高麻醉与手术的安全性。如何合理使用肌松药实现稳定的pNMB还需深入研究和不断探索。

Background Muscle relaxants have generally been avoided during intraoperative neurophysiologic monitoring （IONM） as they can block acetylcholine transmission in neuromuscular junction. Objective This article systematically reviewed the effects of partial neuromuscular blockade（pNMB） on neurophysiological monitoring, and summarize the application of muscle relaxants in IONM. Contents This paper summarized the effects of muscle relaxants on IONM and neurophysiological monitoring with the presence of pNMB. Trend pNMB can offer better conditions for monitoring IONM and improve the safety of anesthesia and surgery. Rational use of muscle relaxants to stabilize pNMB still needs further research and exploration.