Sasaki H
Department of Otolaryngology, Hirosaki University, School of Medicine.
Nihon Jibiinkoka Gakkai Kaiho. 1991 Dec;94(12):1834-43. doi: 10.3950/jibiinkoka.94.12_1834.
Auditory brainstem response (ABR) and auditory middle latency response (MLR) in 128 patients were recorded during the surgical operation which was performed under the various anesthetic methods and conditions. The relation between the anesthetic methods and the characteristics of the auditory evoked responses was investigated. From the results, the anesthesia could be classified into following three types: type A such as enflurane-nitrous oxide-oxygen and halothane-nitrous oxide-oxygen anesthesia by which both ABR and MLR were affected, type B such as thiamylal and diazepam anesthesia by which only MLR was affected, and type C such as neuroleptanesthesia (NLA), high dose fentanyl, ketamine, althesin, spinal and epidural anesthesia, by which both ABR and MLR were not affected. Therefore, when ABR and MLR are recorded as a monitor of the eighth nerve surgery, NLA would be the most adequate and available method. On the other hand, it was proved that ABR and MLR were markedly affected by the decrease of body temperature. Therefore, the decrease of body temperature should be taken into consideration when the auditory evoked response of comatose patients was monitored.
在128例患者接受各种麻醉方法和条件下进行手术时，记录了他们的听性脑干反应（ABR）和听性中潜伏期反应（MLR）。研究了麻醉方法与听觉诱发电位特征之间的关系。结果显示，麻醉可分为以下三种类型：A型，如安氟醚 - 氧化亚氮 - 氧气和氟烷 - 氧化亚氮 - 氧气麻醉，ABR和MLR均受影响；B型，如硫喷妥钠和地西泮麻醉，仅MLR受影响；C型，如神经安定麻醉（NLA）、高剂量芬太尼、氯胺酮、阿法沙龙、脊髓和硬膜外麻醉，ABR和MLR均不受影响。因此，当记录ABR和MLR作为第八神经手术的监测指标时，NLA将是最适当且可行的方法。另一方面，已证明体温下降会显著影响ABR和MLR。因此，在监测昏迷患者的听觉诱发电位时应考虑体温下降的因素。
