右美托咪定对脑干肿瘤手术中运动和感觉诱发电位的影响  

Effects of dexmedetomidine on motor and sensory evoked potentials during brain stem tumor surgery

作　　者：张守文 高路盈 边春生 刘少朋 Zhang Shouwen;Gao Luying;Bian Chunsheng;Liu Shaopeng(Department of Neuroelectrophysiology,Beijing Dawang Road Emergency Rescue Hospital,Beijing City,100122,China;Department of Anesthesiology,Beijing Dawang Road Emergency Rescue Hospital,Beijing City,100122,China)

机构地区：[1]北京大望路急诊抢救医院神经电生理科,北京市100122 [2]北京大望路急诊抢救医院麻醉科,北京市100122

出　　处：《现代电生理学杂志》2022年第3期153-157,共5页Journal of Modern Electrophysiology

摘　　要：目的:探讨右美托咪定(DEX)对脑干肿瘤术中神经电生理监测的影响。方法:选择2019年1月至2022年4月在北京大望路急诊抢救医院就诊的78例脑干肿瘤患者,性别不限,年龄18~75岁,术中进行神经电生理监测。患者随机分为DEX组和对照组,每组39例。观察两组患者经颅运动诱发电位(MEPs)和体感诱发电位(SEPs)的刺激参数和可预测性。结果:与对照组比较,DEX组需要更高经颅电刺激强度[(377.3±38.7)mV比(328.0±35.3)mV,P=0.001]和重复频率[(6.0±0.7)比(5.1±0.5),P=0.037]。MEPs对术后运动结果的预测性显示,与对照组相比,DEX组患者假阳性率更高(27.5%比5.3%,P=0.046)。两组患者SEPs改变结果差异无统计学意义(P>0.05)。结论:在脑干肿瘤手术术中电生理监测中,DEX麻醉可增加MEPs的假阳性率。Objective:To explore the effects of dexmedetomidine(DEX)on intraoperative neurophysiologic monitoring during brain stem tumor surgery.Methods:A total of 78 patients with brain stem tumors from January 2019 to April 2022 in Beijing Dawang Road Emergency Rescue Hospital,both of sexes,aged 18-75 yr,who underwent intraoperative neurophysiologic monitoring,were randomly divided into DEX group and control group,with 39 cases in each group.The stimulation parameters and predictability of transcranial motor evoked potentials(MEPs)and somatosensory evoked potentials(SEPs)in the two groups were observed.Results:The intensity and repetition frequency of transcranial electrical stimulation in the DEX group were significantly higher than those in the control group[(377.3±38.7)mV vs.(328.0±35.3)mV,P=0.001]and[(6.0±0.7)vs.(5.1±0.5),P=0.037].Compared with the control group,the false positive rate in the DEX group was higher(27.5%vs.5.3%,P=0.046).There was no significant difference in the changes of SEPs between the two groups(P>0.05).Conclusion:DEX can increase the false positive rate of MEPs in brain stem tumor surgery.

关 键 词：右美托咪定 脑干肿瘤 诱发电位 运动 诱发电位 躯体感觉 

分 类 号：R614[医药卫生—麻醉学] R739.41[医药卫生—外科学]