不同肌松程度对脊柱外科手术经颅电刺激运动诱发电位监测的临床观察  

Effect of the degree of muscle relaxation on motor-evoked potential elicited by transcranial electrical stimulation in spine surgery

作　　者：李传翔[1] 宋伏虎[1] 王怡[1] 金大地[1] 宋冬梅[1] 陈力[1] 

机构地区：[1]南方医科大学第三附属医院麻醉科,广东广州510630

出　　处：《南方医科大学学报》2010年第12期2686-2688,共3页Journal of Southern Medical University

基　　金：广东省医学科学技术研究基金项目(WSTJJ20081025420300197208040973)

摘　　要：目的研究新型肌肉松弛药顺式阿曲库铵应用于脊柱外科手术,满足手术需要的不同肌松程度对经颅电刺激运动诱发电位影响。方法选择ASAI～II级,欲行择期脊柱外科手术病人60例,随机均分为5组。5组病人在首次推注插管剂量的顺式阿曲库铵后,连续监测T1,以肌松监测反馈调控输注模式调整不同剂量进行持续输注,维持分组的不同肌松程度,观察五组病例术中MEP的D1的波幅及潜伏期。同时对肌松分级进行主观评定。结果在不同的肌松程度下,I组、II组患者的波幅与基准值比较有统计学差异(P<0.05);III组、IV组、V组患者的波幅与基准值比较无统计学差异,组间比较无统计学差异(P>0.05)。肌松主观评定:IV组、V组的肌松评价为差的例数与I组、II组、III组比较有统计学差义(P<0.05)。结论 T1值在10%～15%,既能维持MEP监测的要求,又满足手术需要的肌松程度。Objective To study the effect of the degree of muscle relaxation on motor-evoked potential elicited by transcranial electrical stimulation in patients undergoing spine surgery. Methods Sixty ASA I or II patients undergoing spine surgery were randomly divided into 5 groups （n=12）. After an initial intubation,continuous cisatracurium infusion was administered with continuous monitoring of T1. The infusion dose was adjusted according muscle relaxation monitoring,and different muscle relaxation degrees were maintained in the 5 groups. The band and latency of D1 in motor-evoked potential was observed with also subjective assessment of the muscle relaxation. Results Significant differences in the band and latency were noted in groups I and II compared with the reference values,but not in groups III,IV and V. Subjective assessment revealed significant differences between groups IV and V and groups I and III in terms of the number of cases with poor muscle relaxation. Conclusion T1 value between 10% and 15% is sufficient for MEP monitoring and allows the maintenance of good muscle relaxation during spine surgery.

关 键 词：顺式阿曲库铵 肌松程度 经颅电刺激运动诱发电位 

分 类 号：R614[医药卫生—麻醉学]