全身麻醉对原发性帕金森病患者丘脑底核脑深部电刺激术中微电极记录的影响  

Effect of general anesthesia on microelectrode recording during deep brain stimulation of subthalamic nucleus in patients with primary Parkinson′s disease

作　　者：凌羽婷 刘艺 张丽楠 冼文彪[2] 陈婉如 陈竹宁 杨超[3] 刘金龙[3] 陈玲[2] 黄文起[1] 肖亮灿[1] 江楠[1] Ling Yuting;Liu Yi;Zhang Linan;Xian Wenbiao;Chen Wanru;Chen Zhuning;Yang Chao;Liu Jinlong;Chen Ling;Huang Wenqi;Xiao Liangcan;Jiang Nan(Department of Anesthesiology,First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,China;Department of Neurology,First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,China;Department of Neurosurgery,First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院麻醉科,广州510080 [2]中山大学附属第一医院神经内科,广州510080 [3]中山大学附属第一医院神经外科,广州510080

出　　处：《中华麻醉学杂志》2020年第2期206-209,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价全身麻醉对原发性帕金森患者双侧丘脑底核脑深部电刺激术中微电极记录的影响。方法选择2008年3月至2018年3月行双侧丘脑底核深部电刺激术的原发性帕金森病(病程≥5年和/或有明显症状波动)患者44例,术中进行微电极记录,年龄<80岁,性别不限。采用随机数字表法分为2组:清醒组(n=26)和全麻组(n=18)。清醒组切皮时给予0.5%罗哌卡因切口浸润。全麻组采用靶控输注丙泊酚和瑞芬太尼结合Narcotrend监测麻醉深度的麻醉方案,切皮时给予0.5%罗哌卡因切口浸润。于微电极记录期间,记录总针道次数和丘脑底核长度。分别于术前1周和术后6个月行运动障碍评估,计算运动障碍改善率。记录术后手术麻醉相关、硬件相关和刺激相关等并发症的发生情况。结果 2组总针道次数、丘脑底核长度、术后运动障碍改善率和术后并发症发生率比较差异无统计学意义(P>0.05)。结论全身麻醉不会影响原发性帕金森病患者丘脑底核脑深部电刺激术中微电极的记录。Objective To evaluate the effect of general anesthesia on microelectrode recording(MER)during deep brain stimulation(DBS)of subthalamic nucleus(STN)in the patients with primary Parkinson′s disease(PD).Methods Forty-four patients of both sexes with primary PD(duration of disease≥5 yr and/or obvious symptom fluctuation),undergoing bilateral STN DBS from March 2008 to March 2018,aged<80 yr,were selected and divided into 2 groups by a random number table method:awake group(n=26)and general anesthesia group(n=18).In awake group,0.5%ropivacaine was used for incision infiltration at skin incision.Patients in GA group received propofol and remifentanil by target-controlled infusion with Narcotrend to monitor the depth of anesthesia,and 0.5%ropivacaine was used for incision infiltration at skin incision.The total number of trajectories and length of STN were recorded during MER.Movement disorders were evaluated at 1 week before surgery and 6 months after surgery,and the improvement rate of dyskinesia was calculated.The postoperative anesthesia-,hardware-and stimulation-related complications were recorded.Results There were no significant differences between the two groups in the total number of trajectories,length of STN and improvement rate of postoperative movement disorders(P>0.05).Conclusion General anesthesia does not affect the MER during STN DBS in the patients with primary PD.

关 键 词：麻醉 全身 微电极 丘脑底核 帕金森病 脑深部电刺激术 

分 类 号：R614[医药卫生—麻醉学]