Ghaly R F, Stone J L, Lee J J, Ham J H, Levy W J
Chicago Institute of Neurosurgery and Neuroresearch, Department of Anesthesiology and Pain Management, IL 60614, USA.
Neurol Res. 1999 Jun;21(4):359-67. doi: 10.1080/01616412.1999.11740944.
Monitoring Motor Evoked Potential (MEP) to Transcranial Stimulation (TMS) monitoring (MEP) is a growing technique to assess motor function under anesthesia. The following primate study was conducted to analyze the non-myogenic spinal motor and sensory volleys and to examine their reproducibility under nitrous oxide-methohexidone anesthesia. The traveling periodic spinal descending MEP to TMS and ascending somatosensory (SEP) to posterior tibial nerve stimulation across the thoracic cord were recorded in 12 cynomolgus monkeys. Through a small T11-T12 laminotomy, an insulated stainless steel electrode was inserted into the epidural thoracic space. The potentials were analyzed under 50 vol% NO in O2 with methohexital (0.1-0.2 mg kg-1 min-1). A well-defined periodic TMS-MEPs and PTN-SEPs were recorded with high reproducibility and consistency in repeated trials under N2O-methohexital anesthesia. MEP tracing consisted of an initial peak (direct (D) wave), occurring at 2.43 (+/- 0.28) msec followed by subsequent five positive (indirect (I) waves). Spinal SEPs-MEPs were clearly defined, morphologically stable, and consistent over time under N2O-methohexitone anesthesia. The present primate study may set a model to monitor both modalities in anesthetized neurosurgical patients.
监测经颅刺激(TMS)的运动诱发电位(MEP)是一种在麻醉状态下评估运动功能的不断发展的技术。进行了以下灵长类动物研究,以分析非肌源性脊髓运动和感觉波,并研究它们在氧化亚氮-甲己炔巴比妥麻醉下的可重复性。在12只食蟹猴中记录了经颅磁刺激引发的下行性脊髓运动诱发电位(MEP)以及胫后神经刺激引发的上行性体感诱发电位(SEP)在胸段脊髓的传导情况。通过一个小的T11 - T12椎板切除术,将一个绝缘不锈钢电极插入胸段硬膜外间隙。在50%体积分数的氧气与氧化亚氮混合气体中,使用甲己炔巴比妥(0.1 - 0.2 mg·kg⁻¹·min⁻¹)的情况下对电位进行分析。在氧化亚氮-甲己炔巴比妥麻醉下的重复试验中,记录到了明确的周期性经颅磁刺激运动诱发电位(TMS-MEPs)和胫后神经体感诱发电位(PTN-SEPs),具有高可重复性和一致性。运动诱发电位图由一个初始峰值(直接(D)波)组成,出现在2.43(±0.28)毫秒,随后是五个正向(间接(I)波)。在氧化亚氮-甲己炔巴比妥麻醉下,脊髓体感诱发电位-运动诱发电位清晰可辨,形态稳定,且随时间保持一致。目前的灵长类动物研究可能为监测麻醉状态下神经外科手术患者的这两种模式建立一个模型。