• Br J Anaesth · Oct 1990

    Clinical Trial

    Effect of surface electrode position on the compound action potential evoked by ulnar nerve stimulation during isoflurane anaesthesia.

    • I Kalli.
    • Helsinki University Central Hospital, Department of Anaesthesia, Finland.
    • Br J Anaesth. 1990 Oct 1;65(4):494-9.

    AbstractThe 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) abductor 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.

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