神经外科手术期间行运动诱发电位监测时肌肉松弛药的应用  

Application of muscle relaxant in department of neurosurgery operation under monitoring of motor evoked potential

作　　者：杨进坤 李羽[1] Yang Jinkun;Li Yu(Department of Anesthesiology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院麻醉科,成都610041

出　　处：《国际麻醉学与复苏杂志》2020年第5期498-500,共3页International Journal of Anesthesiology and Resuscitation

基　　金：四川省科技项目基金(2018SZ0217)。

摘　　要：神经外科手术中运动诱发电位(motor evoked potential,MEP)监测至关重要,肌肉松弛药(肌松药)由于影响神经肌肉接头兴奋的传递使监测不能进行而限制其使用。应用小剂量肌松药实现不完全的肌松程度以应用于神经外科手术。文章综述肌松药对MEP监测的影响,详细阐述肌松药在神经外科手术中的应用及在不同肌松药使用方法下MEP监测情况。应用四个成串刺激(train of four,TOF)监测下小剂量的肌松药达到不完全肌松程度能为MEP监测提供良好的监测条件,并提高麻醉与手术的安全性。如何合理应用肌松药实现稳定的不完全肌松程度还需深入研究和不断探索。The monitoring of motor evoked potential(MEP)is very important in neurosurgery.Muscle relaxants cannot be used because they affect the transmission of excitation in neuromuscular junctions.Use small doses of muscle relaxants to achieve incom⁃plete muscle relaxation in neurosurgery.The effects of muscle relaxants on the monitoring of MEP were systematically reviewed.The ap⁃plication of muscle relaxants in neurosurgery was described in detail.In this paper,the effects of muscle relaxants on MEP in neurosur⁃gery and the monitoring of MEP under different methods of muscle relaxants are reviewed in detail and systematically.The application of small doses of muscle relaxants under the train of four(TOF)stimulation monitoring can provide good monitoring conditions for MEP monitoring and improve the safety of anesthesia and surgery.How rationally use muscle relaxants to achieve stable but incomplete mus⁃cle relaxation needs further study and continuous exploration.

关 键 词：肌肉松弛药 运动诱发电位 神经外科 肌松监测 

分 类 号：R614[医药卫生—麻醉学]