Kasaba T, Nonoue T, Yanagidani T, Maeda M, Aoki S, Sakaguchi T, Kosaka Y
Department of Anesthesia, Tottori Prefectural Central Hospital.
Masui. 1991 Jan;40(1):16-20.
Auditory brainstem responses (ABR) are used increasingly to monitor the integrity of neural pathways in anesthetized patients. To evaluate the effect of epidural anesthesia on the central nervous system, we studied the effects of lumbar epidural anesthesia with lidocaine on the ABR in 10 patients. The seven peak latencies (waves I-VII) and amplitudes (waves I-VII) of the ABR were recorded before and 15 min after epidural anesthesia. Peak latencies of waves III, IV, V, VI, VII increased after epidural anesthesia compared with control values. Amplitude of waves II only decreased significantly following epidural anesthesia compared with control values. We further compared the interpeak latencies to investigate the brainstem transmission. Interpeak latencies (I-II, II-III, III-IV, IV-V, V-VI, VI-VII) were unchanged from the control values except waves VI-VII interval. Interpeak latencies of every second peak (II-IV, IV-VI, V-VII), of every third peak (II-V, III-VI, IV-VII), of every forth peak (I-VI, II-VII), of every fifth peak (I-VII) increased after epidural anesthesia compared with control values. The data obtained in the study demonstrated that lumbar epidural anesthesia with lidocaine prolonged the interpeak latencies of ABR. Considering that the waves of ABR are related to anatomically distinct sites in the auditory pathway (I; Acoustic nerve, II; Cochlear nucleus, III; Superior olivary complex, IV; Lateral lemniscus, V; Inferior colliculus, VI: Medial geniculate body, VII; Auditory radiation), the delay in the latencies of ABR seems to be present in the time intervals which involve more than two or three synaptic transmissions.
听觉脑干反应（ABR）越来越多地用于监测麻醉患者神经通路的完整性。为了评估硬膜外麻醉对中枢神经系统的影响，我们研究了10例患者使用利多卡因进行腰段硬膜外麻醉对ABR的影响。在硬膜外麻醉前和麻醉后15分钟记录ABR的七个峰潜伏期（波I-VII）和波幅（波I-VII）。与对照值相比，硬膜外麻醉后波III、IV、V、VI、VII的峰潜伏期增加。与对照值相比，仅硬膜外麻醉后波II的波幅显著降低。我们进一步比较了峰间潜伏期以研究脑干传导。除波VI-VII间期外，峰间潜伏期（I-II、II-III、III-IV、IV-V、V-VI、VI-VII）与对照值无变化。与对照值相比，硬膜外麻醉后每隔一个波峰（II-IV、IV-VI、V-VII）、每隔两个波峰（II-V、III-VI、IV-VII）、每隔三个波峰（I-VI、II-VII）、每隔四个波峰（I-VII）的峰间潜伏期增加。该研究获得的数据表明，利多卡因腰段硬膜外麻醉延长了ABR的峰间潜伏期。鉴于ABR的波与听觉通路中解剖学上不同的部位相关（I；听神经，II；蜗神经核，III；上橄榄复合体，IV；外侧丘系，V；下丘，VI：内侧膝状体，VII；听辐射），ABR潜伏期的延迟似乎出现在涉及两个或三个以上突触传递的时间间隔中。
