Muscle relaxation and depth of anaesthesia: where is the missing link?

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Presentation transcript:

Muscle relaxation and depth of anaesthesia: where is the missing link? V. Bonhomme, P. Hans British Journal of Anaesthesia Volume 99, Issue 4, Pages 456-460 (October 2007) DOI: 10.1093/bja/aem243 Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 1 Schematic representation of possible mechanisms through which muscle relaxation may influence depth of anaesthesia (DOA), or what is measured as depth of anaesthesia (DOA index). (1): muscle relaxation may reduce muscle tone and proprioceptive afferences to the brain (speculative). (2): atracurium or metabolites such as laudanosine may have anti-nociceptive properties, limit nociceptive inputs, and facial EMG responses to nociceptive stimulation (speculative). (3): muscle relaxation reduces facial EMG activity. 4: DOA monitor algorithm, filters, and artefact rejection systems will determine to what extent the calculation of the depth of anaesthesia index value will be affected by EMG activity and muscle relaxation. British Journal of Anaesthesia 2007 99, 456-460DOI: (10.1093/bja/aem243) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions