Yamamoto Yuri, Kawaguchi Masahiko, Kakimoto Meiko, Inoue Satoki, Furuya Hitoshi
Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan.
Anesth Analg. 2007 Jun;104(6):1488-92, table of contents. doi: 10.1213/01.ane.0000261518.62873.91.
Dexmedetomidine is used in the perioperative management of patients, including as an intraoperative adjuvant. The effects of dexmedetomidine on myogenic motor evoked potentials (MEPs) remain undetermined. We conducted the present study to investigate the effects of dexmedetomidine on myogenic MEPs in rabbits.
New Zealand white rabbits were used for the studies. First, to determine appropriate doses of dexmedetomidine as an adjunct for anesthesia in rabbits, the level of anesthesia was evaluated by testing the palpebral and limb withdrawal reflexes, and the reactions to ear pinching and tail clamp at 5, 25, 50, 100 microg/kg/h. Second, in 10 rabbits under ketamine and fentanyl anesthesia, myogenic MEPs in response to single pulse and a train-of-five pulses were recorded from the soleus muscle before, during, and after the administration of dexmedetomidine at 5, 25, and 50 microg/kg/h.
At 50 microg/kg/h of dexmedetomidine, palpebral reflex, limb reflex, and reaction to ear pinching were inhibited in >50% of animals, but the reaction to tail clamp was not reduced. Dexmedetomidine suppressed myogenic MEPs in a dose-dependent manner, but when multipulses were used for stimulation, myogenic MEPs could be recorded in all animals at 50 microg/kg/h.
As long as multipulse is used for stimulation, the recording of myogenic MEPs is feasible in rabbits under ketamine and fentanyl anesthesia during the administration of dexmedetomidine at doses that are an adjunct to anesthesia.
右美托咪定用于患者围手术期管理,包括作为术中辅助用药。右美托咪定对肌源性运动诱发电位(MEP)的影响尚不确定。我们开展本研究以探讨右美托咪定对兔肌源性MEP的影响。
使用新西兰白兔进行研究。首先,为确定右美托咪定作为兔麻醉辅助用药的合适剂量,通过测试睑反射和肢体退缩反射以及在5、25、50、100微克/千克/小时剂量下对夹耳和夹尾的反应来评估麻醉水平。其次,在10只接受氯胺酮和芬太尼麻醉的兔中,在给予5、25和50微克/千克/小时右美托咪定之前、期间和之后,记录比目鱼肌对单脉冲和五个脉冲串刺激的肌源性MEP。
右美托咪定剂量为50微克/千克/小时时,超过50%的动物睑反射、肢体反射和对夹耳的反应受到抑制,但对夹尾的反应未减弱。右美托咪定以剂量依赖方式抑制肌源性MEP,但当使用多脉冲刺激时,在所有动物中50微克/千克/小时剂量下均可记录到肌源性MEP。
只要使用多脉冲刺激,在氯胺酮和芬太尼麻醉的兔中,在给予作为麻醉辅助用药剂量的右美托咪定期间记录肌源性MEP是可行的。