Abstract
Introduction: Many specialists believe that neuromuscular blockade is most effective if the injection is placed close to the major motor points of the muscle. This study aimed to produce a ‘user-friendly’ map of injection sites by combining data from existing literature, recent anatomical dissections and information obtained clinically at the time of botulinum toxin injection.
Methods: A literature search collected all clinically relevant anatomical data regarding the identification of motor points in various muscles. Where data was lacking, anatomical dissections were performed on cadaveric specimens. These specimens were also used to ‘confirm’ the existing published data. All motor points measurements were then related to a series of surface anatomy lines that were easily identifiable in a patient with neuromuscular disability. Over the last year, 150 ‘motor points’ have been identified in patients undergoing neuromuscular blockade using a nerve stimulator and related to the same surface markings used in the cadaveric studies. Good correlation between existing literature and our cadaveric studies was found. New data was collected for forearm flexors, adductors and shoulder muscles. The correlation between clinical and anatomical motor points was good with errors averaging 5% of the measured distance.
Conclusion: A ‘Body Map’ is being produced that can be displayed in clinical areas to facilitate the use and improve the efficacy of neuromuscular blockade and encourage its use in the outpatient setting.
The abstracts were prepared by Editorial Secretary, Mr Robin W Paton. Correspondence should be addressed to BSCOS at the Royal College of Surgeons, 35– 43 Lincoln’s Inn Fields, London WC2A 3PN
