Kawaguchi Masahiko, Furuya Hitoshi
Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan.
Masui. 2006 Mar;55(3):294-301.
Motor dysfunction following spinal surgery and thoracoabdominal aortic surgery remain as one of their devastating complications. Since the development of postoperative motor dysfunction can deteriorate quality of life of patients, the prevention of such complications is an important clinical challenge. Recently, advances in stimulation technique using multipulse made intraoperative monitoring of functional integrity of motor pathways possible by recording myogenic motor evoked potentials (MEPs). However, myogenic MEPs can be affected by most of anesthetic agents and muscle relaxants. Anesthesiologists are therefore required to properly understand MEPs and to manage anesthesia carefully. We summarize the methods for monitoring of myogenic MEPs and anesthetic techniques during intraoperative MEP monitoring.
脊柱手术和胸腹主动脉手术后的运动功能障碍仍然是其极具破坏性的并发症之一。由于术后运动功能障碍的发展会使患者的生活质量恶化,预防此类并发症是一项重要的临床挑战。最近,多脉冲刺激技术的进步使得通过记录肌源性运动诱发电位(MEP)对运动通路的功能完整性进行术中监测成为可能。然而,肌源性MEP会受到大多数麻醉剂和肌肉松弛剂的影响。因此,麻醉医生需要正确理解MEP并谨慎管理麻醉。我们总结了术中MEP监测期间肌源性MEP的监测方法和麻醉技术。