七氟醚和异丙酚对上肢体感诱发电位的影响  

Effects of sevoflurane and propofol upon the moritoring by SEP in operation

作　　者：李群喜[1] 乔慧[2] 李建珉[1] 朱军[1] 刘淑玲[2] 王明然[2] 刘莉[2] 

机构地区：[1]华北煤炭医学院附属医院神经外科,河北唐山063000 [2]北京市神经外科研究所

出　　处：《临床神经电生理学杂志》2007年第4期199-203,共5页Journal of Clinical Electroneurophysiology

摘　　要：目的:比较全麻药物异丙酚和不同浓度的七氟醚对病人的体感诱发电位(SEP)监测结果的影响。方法:选取50例全麻手术病人,随机分为七氟醚(S)组30例和异丙酚(P)组20例。S组于诱导后吸入七氟醚,使肺泡内七氟醚浓度依次达到0.5、1.0、1.5 MAC,并分别将其作为观察点作SEP术中监测;P组于诱导后全凭静脉稳定泵入异丙酚,并分别将诱导后泵入前、泵入后15、30、45 min作为观察点作SEP术中监测。记录两组麻醉前及上述各时点的SEP波幅、潜伏期变化。结果:S组随着麻醉深度的改变和七氟醚浓度的增加,其SEP潜伏期明显延长,波幅明显下降,在各肺泡七氟醚浓度之间比较差异有极显著意义(P<0.001)。P组平稳麻醉各时点对SEP潜伏期及波幅的影响小,其间差异无统计学意义(P>0.05)。结论:麻醉时吸入性麻醉药物七氟醚对SEP波幅、潜伏期有明显影响,吸入浓度小于1.0 MAC时SEP较为稳定,麻醉效果较为理想;异丙酚全凭静脉麻醉对SEP影响较小。Objective：To compare the effects of sevoflurane of different concentrations and propofol upon the monitoring by short-latency somatosensory evoked potentials（SEP） in forearms in operation. Methods： 50 intraoperative patients in anaethesia were randomly divided into two groups：S group and P group. In S group, after tracheal intubation, sevoflurane was inhaled and sevoflurane concentrations of intraalveoli reached to 0.5 MAC,1.0 MAC and 1.5 MAC in turn. In P group , propofol was used intravenously, intravenous points of observation were respectively at the 15th , 30th and 45th minute. Latency and amplitude of SEP were recorded in both groups. Results： With increasing concentrations of sevoflurane,there was a progressive increase in latency and decrease in amplitude （P〈0. 001） of SEP of the forearms. But propofol of intravenous gunae had no significant change （P〉0. 05） . Conclusion： As sevoflurane inhaled concentration is lower than 1.0 MAC , the monitoring of SEP is rether stable,and the effect of anaethesia is desrable. Propofol of intravenous guttae have no significant effect on SEP.

关 键 词：体感诱发电位(SEP) 术中监测 麻醉 异丙酚 七氟醚 

分 类 号：R971.2[医药卫生—药品] R741.044[医药卫生—药学]