小剂量利多卡因复合丙泊酚对颅内肿瘤切除老年病人运动诱发电位的影响  

Effect of low-dose lidocaine combined with propofol on motor evoked potential in elderly patients undergoing intracranial tumor resection

作　　者：刘美娟 王宁[1] 王栋 陆方舟 刘娟[1] LIU Meijuan;WANG Ning;WANG Dong;LU Fangzhou;LIU Juan(Department of Anesthesiology,Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Neurosurgery,Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院麻醉科,江苏省南京市210029 [2]南京医科大学附属脑科医院神经外科,江苏省南京市210029

出　　处：《实用老年医学》2024年第8期808-811,830,共5页Practical Geriatrics

摘　　要：目的探讨小剂量利多卡因复合丙泊酚对老年颅内肿瘤切除术病人术中运动诱发电位(MEP)的影响。方法选择全麻下行颅内肿瘤切除的老年病人44例为研究对象,采用随机数表法将其分为利多卡因组(L组)和对照组(C组),每组22例。所有病人均给予丙泊酚麻醉处理,L组复合使用小剂量利多卡因,C组给予等量生理盐水,术中均行MEP监测。记录2组病人麻醉期间的平均动脉压(MAP)、心率(HR)、麻醉深度、MEP波幅和潜伏期、丙泊酚用量及不良反应发生情况。结果麻醉期间,C组不同时点HR及MAP存在明显波动,差异有统计学意义(P<0.05),L组HR及MAP未见明显波动(P>0.05);2组MEP波幅和潜伏期差异均无统计学意义(P>0.05),但L组丙泊酚用量及不良反应发生率明显低于C组(P<0.05)。结论小剂量利多卡因对颅内肿瘤老年手术病人MEP波幅和潜伏期均无显著影响,但有利于维持血流动力学稳定,减少术中丙泊酚用量,降低不良反应发生率。Objective To investigate the effect of low-dose lidocaine combined with propofol on motor evoked potential(MEP)in the elderly patients undergoing intracranial tumor resection.Methods A total of 44 elderly patients receiving intracranial tumor resection monitored by MEP under general anesthesia were enrolled in this study,and were divided into lidocaine group(group L)and control group(group C)by random number table method,with 22 cases in each group.All patients were anesthetized with propofol.The patients in group L received low-dose lidocaine additionally,while the patients in group C was given equal amount of normal saline.The mean arterial pressure(MAP),heart rate(HR),depth of anesthesia,MEP amplitude and latency,propofol dosage and the occurrence of adverse reactions were recorded and compared between the two groups at different time during anesthesia.Results The levels of HR and MAP at different time showed statistically significant differences in group C(P<0.05),while showing no significant differences in group L(P>0.05).During anesthesia,there were no significant differences in MEP amplitude and latency between the two groups(P>0.05),but the dosage of propofol and the incidence rate of adverse reactions in group L were significantly lower than those in group C(P<0.05).Conclusions Low-dose lidocaine has no significant effect on the amplitude and latency of MEP in the elderly patients undergoing surgery for intracranial tumor,which is conductive to maintain hemodynamic stability,reduce intraoperative propofol dosage and the incidence of adverse reactions.

关 键 词：利多卡因 丙泊酚 老年人 颅内肿瘤 经颅电刺激 运动诱发电位 

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