异丙酚麻醉下气管插管对正中神经体感诱发电位的影响  

Effects of tracheal intubation on median nerve somatosensory evoked potential under propofol anesthesia

作　　者：杨涛[1] 陈瑞霞[1] 杜素娟[1] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,510120

出　　处：《岭南现代临床外科》2014年第4期424-427,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的 观察异丙酚诱导下气管插管对正中神经体感诱发电位（MnSSEP）的影响,探讨正中神经体感诱发电位用于监测气管插管引起的伤害性刺激反应的可行性.方法 18～40岁病人20例（8男,12女）,异丙酚效应室浓度达5 μg· mL^-1并用司可林后行气管插管,记录插管前、中、后的MnSSEP、BIS、SBP、DBP、HR.结果 气管插管前后MnSSEP各波潜伏期、BIS和HR均无改变.插管即刻MnSSEP的P15N20、N20P25波幅增高,插管后N20P25恢复,P15N20仍增高,其余波幅无改变.插管即刻和插管后SBP、DBP较插管前增高.结论 正中神经体感诱发电位的N20P25波幅较BIS更适于反映气管插管引起的伤害性刺激.Objective To observe the effect of tracheal intubation on MnSSEP, investigate the feasibility of median nerve somatosensory evoked potentials for monitoring the noxious stimuli response of intubation. Methods Sixteen ASA I - II patients （8 male, 12 female） aged 18-40 yrs undergoing elective surgery under general anaesthesia. Anaesthesia was induced with TCI propofol. After the target effect-site concentration of propofol reach 5 μg· mL^-1 and maintained for two minutes, intubation was facilitated by succinylcholine and MnSSEP, BIS, SBP, DBP, and HR of before, during and after intubation were recorded. Results There were no changes in all latencies of MnSSEP, BIS and HR. During intubation amplitudes of N20P25 increased, and after that they reinstated. SBP, DBP and the Amplitude of P15N20 increased during and after intubation. Conclusion Amplitude of N20P25 is suitable to reflect the effects of the noxious stimuli to tracheal intubation.

关 键 词：插管法 气管内 诱发电位 躯体感觉 伤害性刺激 

分 类 号：R444[医药卫生—诊断学] R614[医药卫生—临床医学]