摘要
目的 比较麻醉深度和神经肌肉阻滞程度对经颅磁刺激运动诱发电位 (tcMMEPs)的影响。方法 2 5例择期行脊髓手术的病人 ,分别在清醒时及BIS值为 75～ 6 5、6 5～ 5 5和 5 0～ 30时记录tcMMEPs的波形 ;维持肌松使 4个成串刺激的第一个刺激T1在 5 0 %左右 ,重复上述实验。结果 (1)在没有神经肌肉阻滞时 ,麻醉后tcMMEPs的波幅在各BIS值范围内与清醒时相比均显著减小 (P <0 0 0 1) ,但随后并不随着麻醉的继续加深而下降 (P >0 0 5 ) ,只有当BIS值达到 5 0～ 30的范围时其波幅与BIS值在 75～ 6 5时相比才有显著下降 (P <0 0 0 1)。 (2 )当T1在 5 0 %左右时 ,各BIS值范围内的波幅与清醒时相比均有非常显著差异 (P <0 0 0 1) ,且每个BIS范围内的数值与同组T1为 10 0 %时相比均有显著性差异 (P <0 0 0 1) ,而各BIS范围之间的波幅无显著性差异 (P >0 0 5 )。
Objective To compare the influence of anesthesia depth and neuromuscular blockade on transcranial magnatic motor evoked potentials(tcMMEPs).Methods Twenty five patients undergoing elective spinal surgery were involved.To record the waves of tcMMEPs at following periods:awake and bispectral index(BIS) at 75 65,65 55,50 30 respectively.Under the T 1 value of TOF at about 50%,the study as above was repeated.Results (1)Without neuromuscular blockade,the amplitude of tcMMEPs after anesthesia decreased significantly compared to that before at all BIS levels( P< 0 001).The amplitudes had no change when anesthesia was deepened until BIS was at 50 30,after which it was decreased significantly( P< 0 001).(2)When T 1 was at 50%,all amplitude values had significant differences compared with the value of awake ( P< 0 001),and was significantly smaller than those of T 1=100% at the same BIS ( P< 0 001).There was no difference in the amplitudes among the BIS ranges( P> 0 05).Conclusions The influence of neuromuscular blockade on the amplitude of tcMMEPs is greater than that of anesthesia depth. [
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第2期84-86,共3页
Journal of Clinical Anesthesiology
