Non-linear regression analysis for estimating the intraoperative motor evoked potential recovery time after bolus neuromuscular blockade

J Clin Monit Comput. 2021 Dec;35(6):1333-1339. doi: 10.1007/s10877-020-00600-0. Epub 2020 Oct 9.

Abstract

The recovery time of the motor evoked potential (MEP) amplitude following a neuromuscular blockade (NMB) during surgery is useful for interpreting low-amplitude waveforms or selecting the baseline waveform. In this study, the MEP data of 195 orthopedic cases who received a bolus dose of rocuronium at the beginning of surgery, between June 2009 and January 2016 were used. A non-linear regression analysis was applied to MEP amplitude data of multiple patients. The time taken for 90% of the maximum-amplitude recovery was estimated from the identified time series model. The 90% amplitude recovery time was 88.6 min in the pharmacological model and 89.4 min in the logistic model. These results were included in the 95% confidence interval of the previous studies. Although MEP amplitude is relatively unstable because of anesthesia, the averaged time series model of MEP amplitude can be estimated by using a large number of data.

Keywords: MEP; Motor evoked potential; Neuromuscular blockade; Non-depolarizing muscle relaxant; Non-linear regression analysis; Pharmacodynamics model; Pharmacokinetics model.

MeSH terms

  • Anesthetics* / pharmacology
  • Evoked Potentials, Motor
  • Humans
  • Neuromuscular Blockade*
  • Regression Analysis
  • Rocuronium / pharmacology

Substances

  • Anesthetics
  • Rocuronium