Department of Anesthesiology, Intensive Care and Pain Therapy, St. Georg's Hospital, Delitzscher Str. 141, 04129 Leipzig, Germany.
Clin Neurophysiol. 2011 May;122(5):1048-54. doi: 10.1016/j.clinph.2010.08.017. Epub 2010 Oct 20.
The reliability of intra-operative recordings of trigeminal scalp-induced somatosensory-evoked potentials (T-SSEP) is controversial. This investigation aimed to provide evidence that T-SSEP recordings are stable using standardised neurophysiological methodology and anaesthesiological regime.
We investigated 99 patients undergoing carotid endarterectomy under total intravenous anaesthesia (propofol/remifentanil infusion). Long-latency T-SSEPs were recorded from the scalp after simultaneously stimulating 2nd and 3rd branches of the trigeminal nerve. The analysis included visual assessments of traces and measurements of latencies and amplitudes of the N13 and P19 peaks of T-SSEP. Furthermore, additional groups of patients were investigated to identify changes in the parameters of T-SSEP that might correspond to different states of anaesthesia and artificial muscle activity.
We reproducibly recorded T-SSEP responses in 99 patients with a mean latency of 12.4 ms (SD=0.93) and amplitude of 5.7 μV (SD=4.7). Collateral investigations concerning changes of T-SSEP caused by neuromuscular blockade improved independence of T-SSEP recordings to muscle relaxation in contrast to facial and cervical muscle activity.
We demonstrated the reliability of recording stable intra-operative T-SSEP responses with standardised electrophysiological and anaesthesiological regimes.
We provided evidence of the non-muscular origin of T-SSEPs recorded from the scalp.
术中记录三叉神经头皮诱发体感诱发电位（T-SSEP）的可靠性存在争议。本研究旨在通过标准化的神经生理方法和麻醉方案提供 T-SSEP 记录稳定的证据。
我们研究了 99 例在全静脉麻醉（丙泊酚/瑞芬太尼输注）下接受颈动脉内膜切除术的患者。在同时刺激三叉神经第 2 和第 3 分支后，从头皮上记录长潜伏期 T-SSEP。分析包括对迹线进行视觉评估以及测量 T-SSEP 的 N13 和 P19 峰的潜伏期和振幅。此外，还对其他患者组进行了调查，以确定可能与不同麻醉状态和人工肌肉活动相对应的 T-SSEP 参数变化。
我们在 99 例患者中可重复性地记录了 T-SSEP 反应，平均潜伏期为 12.4ms（SD=0.93），振幅为 5.7μV（SD=4.7）。关于由神经肌肉阻滞引起的 T-SSEP 变化的进一步研究，与面部和颈部肌肉活动相比，提高了 T-SSEP 记录对肌肉松弛的独立性。
我们证明了在标准化的电生理和麻醉方案下记录稳定的术中 T-SSEP 反应的可靠性。
我们提供了从头皮记录的 T-SSEP 来源于非肌肉的证据。
