摘要
目的：为进一步阐明静脉普鲁卡因到底有无麻醉作用。方法：２０例患者随机分成普鲁卡因组和普鲁卡因加芬太尼组，观察脑电功率谱相对功率、９０％谱边界频率（ＳＥＦ）、中位频率（ＭＰＦ）和中潜伏期听觉诱发电位（ＭＬＡＥＰ）的变化。结果：ＳＥＦ、ＭＰＦ不随剂量的逐级递增而进一步改变，呈快波β节律活动显著增加的脑干兴奋的去同步化ＥＥＧ表现。但达２ｍｇ／ｋｇ·ｍｉｎ时，ＳＥＦ、ＭＰＦ和β相对功率出现骤降（Ｐ＜００１），呈δ波占绝对优势（５０６０％）的ＥＥＧ表现。ＭＬＡＥＰＰａ、Ｎｂ波潜伏期于１ｍｇ／ｋｇ·ｍｉｎ即已明显延长，振幅降低更为显著，其变化与普鲁卡因剂量呈线性关系。加用芬太尼组的改变与普鲁卡因组在２ｍｇ时几乎一致。结论：普鲁卡因的麻醉作用是肯定的，但仅能达到相当于Ⅱ期的麻醉深度；加用芬太尼完全可以使静脉普鲁卡因麻醉的较浅状态得以加深，达到类似强效麻醉药的麻醉深度。
Objectives: To study the effect and the degree of intrevenous
procaine anesthesia. Methods: Twenty patients were anesthetized for 30 min by infusion of
procaine at a dose of 1.0, 1.5 and 2.0 mg/kgmin respectively or by a combination of procaine (1.
0 mg/kg/min) and fentanyl (10 mgkg). The EEG relative power spectral edge frequency (SEF
90%), median power frequency (MPF) and the midlatency auditory evoked potential (MLAEP)
were observed. Results: SEF and MPF were constantly maintained at a high level during
intravenous procaine anesthesia before the dose reached 2.0 mg/kgmin, and did not change
with the increase in dosage. However, SEF, MPF and relative power dropped suddenly (P<0.01)
and relative power began to predominate when the dosage reached 2.0 mg/kgmin. The latency
of Pa and Nb of MLAEP were greatly prolonged at a dosage of 1.0 mg/kgmin, and the amplitude
was reduced. This change was related linearly to the dosage of procaine. However, the change
in fentanyl group was almost identical to that in procaine group. Conclusions: The action of
intravenous procaine anesthesia was confirmed, but the degree of anesthesia was only
corresponding to stage . The degree could be deepened in combination with fentanyl, reaching
a degree as the effect of potent anesthetics did. It was speculated that the site of the central
anesthetic action of procaine might be in the subcortical structure, midbrain and primary
auditory cortex level.
关键词
普鲁卡因
麻醉
脑电功率谱
听觉诱发电位
电生理
AnesthesiaProcaineFentanylEEG power spectrumAuditory
evoked potentialMidlatency
