诱发电位与异氟醚麻醉后苏醒的关系  

Relationship between evoked potential and recovery after isoflurane anesthesia

作　　者：张捍平[1] 柴伟[2] 杜洪印[2] 赵辉[2] 杨永慧[2] 孙绪德[2] 于代华[2] 

机构地区：[1]武警江苏省总队医院麻醉科,江苏扬州225003 [2]第四军医大学唐都医院麻醉科,陕西西安710038

出　　处：《第四军医大学学报》2005年第14期1321-1323,共3页Journal of the Fourth Military Medical University

摘　　要：目的:探讨EP与苏醒时间的关系,以期找到EP监测麻醉苏醒的客观指标.方法:20例择期全麻腹部手术患者,诱导后异氟醚单纯吸入维持麻醉.麻醉停药前随机以不同呼末异氟醚浓度,每个浓度平衡15min后,记录SEP,AEP和呼末异氟醚浓度,并观察停药后指令反应时间、拔管时间及达到ModifyAldreteScore≥9时间.结果:①EP波幅变异较大,与苏醒无相关性.②AEP各波潜伏期与苏醒呈相关性,Nb波在异氟醚的浓度下保持完整,其潜伏期变化与苏醒各项指标呈显著相关性.③SEP的N20潜伏期无明显改变;N35则变异较大,与苏醒无明显相关性;P25与苏醒呈线性关系.④呼气末异氟醚浓度与苏醒相关性显著低于Nb,P25潜伏期.⑤各指标与苏醒相关系数依次为Nb潜伏期>P25潜伏期>呼气末异氟醚浓度.结论:AEP的Nb潜伏期及SEP的P25潜伏期与苏醒各指标密切相关,Nb,P25潜伏期是反映异氟醚麻醉后苏醒时间的可靠指标.AIM: To investigate the relationship between evoked potential (EP) and recovery time after isoflurane anesthesia for some credible parameters in recovery monitoring after isoflurane anesthesia. METHODS: Twenty patients undergoing abdominal surgery under elective general anesthesia were maintained with isoflurane after induction. SEP, AEP and the end-expiratory concentration of isoflurane were recorded before the discontinuation of isoflurane at different concentrations for 15 min. Commander reflect time, extubation time and the time to reach modified Aldrete score ≥ 9 were observed from the end of anesthesia. RESULTS: ① The amplitude of EP had a big variance and was not correlated with recovery time. ② The latency of all waves in AEP was correlated with recovery time. The change of Nb latency was correlated with all recovery-related indexes. ③ There was no significant variance in the N20 latency of SEP but there was a big variance in the latency of N35, which was not correlated with recovery time. The latency of P25 was correlated with recovery time. ④ Nb and P25 had a better correlation with recovery time than end-expiratory concentration of isoflurane. ⑤ The correlation coefficients of all indexes with recovery time were Nb latency > P25 latency > the end-expiratory concentration of inhaled anesthetics. CONCLUSION: ① The Nb latency of AEP and the P25 latency of SEP are significantly correlated with the command reflect time, extubation time and the time to reach modified Aldrete score ≥ 9. The latency of Nb and P25 are credible indexes in the determination of recovery time after inhaled anesthesia.

关 键 词：诱发电位 异氟醚 苏醒 意识 

分 类 号：R614[医药卫生—麻醉学]