不同肌松程度对脊柱手术皮层体感诱发电位的监测  

Different Degrees of Muscle Relaxation Affecting Cortical Somatosensory Evoked Potential in Spine Surgery

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

机构地区：[1]南方医科大学第三附属医院麻醉科,广州510630

出　　处：《中国中西医结合外科杂志》2011年第2期168-170,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

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

摘　　要：目的:了解新型肌肉松弛药顺式阿曲库铵用于脊柱外科手术,肌松程度对皮层体感诱发电位(CSEP)监测的影响。方法:选择ASAI～II级,择期脊柱外科手术病人60例,随机分为6组。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输注,维持各分组所要求的不同肌松程度,观察6组病例术中CSEP的P40波的波幅及潜伏期。同时对肌松分级进行主观评定。结果:在不同的肌松程度下,IV组、V组及VI组患者的波幅与基准值比较有统计学差异(P<0.05);I组、II组、III组患者的波幅与基准值比较无统计学差异(P>0.05)。肌松主观评定,V组、VI组患者肌松评价差的例数与I组、II组、III组、IV组比较有统计学差义(P<0.05)。结论:能满足CSEP监测的要求,同时也能满足手术及运动诱发电位监测需要的肌松程度是T1值在0～15%。Objective To research novel muscle relaxation of cisatracurium used in spine surgery and to observe different degrees of muscle relaxation affecting cortical somatosensory evoked potential.Methods Sixty ASA I or II patients undergoing spine surgery were randomly divided into six groups（n=10 each）.After six groups at the first time to push the intubation dose with cisatracurium,continuous infusion with the feedback infusion pattern according muscle relaxation monitoring was made and different groups of muscle degree were maintained.The band and latency of P40 in motor evoked potential were observed.The subjective assessment to muscle relaxation was made at the same time.Results In different degrees of muscle relaxation,there were significant differences of the band and latency between group IV,group V and group VI as compared with reference value.No significant difference of the band and latency among group I,group II and group III compared with reference value.There were significant differences between group V,group VI as compared with group I,group II,group III and group IV in the mount of the subjective assessment with worse.Conclusion T1 in 0-15% is satisfied with monitoring to CSEP and can maintain good muscle relaxation classification.

关 键 词：顺式阿曲库铵 肌松程度 皮层体感诱发电位 

分 类 号：R971.8[医药卫生—药品]