Compare the Operating Condition of Two Levels of Muscle Relaxation on Facial Nerve MEP Monitoring in CPA Surgery

Intraoperative Monitoring of Facial Nerve in Patients Undergoing Cerbellopontine Angle Tumer Resection Using Partial Versus no Neuromuscular Block

compare the operating condition of two different levels of muscle relaxation on facial nerve monitoring using transcranial motor evocked potential in CPA surgery .

• To Estimate End to start facial nerve MEP amplitude ratio
• To determine the effect of neuromuscular relaxant degrees on recovery and
• Assessment of propofol doses needed for enhancement of early recovery and ambulation.

40 Patients aged from 18-60 years old undergoing Cerebellopontine angle surgery. Patients will be one of two groups: Both Induction will be accomplished with fentanyl, propofol , rocronium infusion will be given randomly to one of the groups.

Depth of anaesthesia, neurotransmitter monitoring and facial nerve neurophysiological monitoring will be done.

Inclusion Criteria:

• Patients age between >18 and<60.
• Patients scheduled for neurosurgical CPA surgeries
• Ability to sign the consent
• ASA classification I, II

Exclusion Criteria:

• ASA > II
• Hemodynamically unstable
• Disease affecting neuromuscular transmission (myasthenia gravies ...etc.)
• GCS < 15.
• Any cardiac patient (ischemic heart disease - cardiomyopathy...etc.)