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右美托咪定-依托咪酯-芬太尼复合麻醉对脊柱手术患者体感诱发电位和运动诱发电位的影响

Effect of dexmedetomidine-etomidate-fentanyl combined anesthesia on somatosensory- and motor-evoked potentials in patients undergoing spinal surgery.

作者信息

Lin Sheng, Dai Na, Cheng Zhengyan, Shao Wei, Fu Zhijian

机构信息

Department of Anesthesiology, Yantai Shan Hospital, Yantai, Shandong 264001, P.R. China ; Shandong University, Jinan, Shandong 250001, P.R. China.

Public Management Department, Yantai Vocational College, Yantai, Shandong 264001, P.R. China.

出版信息

Exp Ther Med. 2014 May;7(5):1383-1387. doi: 10.3892/etm.2014.1555. Epub 2014 Feb 18.

Abstract

This aim of the present study was to evaluate the effects of dexmedetomidine (DEX) on the intraoperative monitoring of somatosensory-evoked potentials (SEPs) and motor-evoked potentials (MEPs) in patients undergoing spinal surgery. A total of 36 patients who received spinal surgery under general anesthesia were randomly divided into two groups (n=18 per group), group C, the test group and group D, the control group, and these groups were subjected to a matching anesthesia induction. In brief, the anesthesia was administered via injection of etomidate and fentanyl; once the patients were unconscious, a laryngeal mask airway (LMA) was inserted, SEPs and MEPs were monitored and the collected data were considered to be basic data. Cisatracurium was subsequently injected and an endotracheal tube (7#) was inserted to replace the LMA. The following procedures were conducted for anesthesia maintenance: Group C, the anesthesia was maintained via target-controlled infusion of etomidate and intermittent injection of fentanyl; and group D, DEX (0.5 μg/kg) was injected over a duration of 10 min and then pumped at a rate of 0.5 μg/kg/h. In the two groups, all of the other drugs used were the same and a muscle relaxant was not administered. The bispectral index was maintained between 45 and 55 during surgery, and the SEPs and MEPs were monitored continuously until the surgery was completed. No significant difference in duration and amplitude of the SEPs (P15-N20) was identified between group C and D (P>0.05). Furthermore, the MEPs were monitored in the two groups at specific durations and no significant difference was observed between the two groups (P>0.05). The SEPs and MEPs were maintained in the patients who were administered with the DEX-etomidate-fentanyl combined anesthesia during spinal surgery.

摘要

本研究的目的是评估右美托咪定(DEX)对脊柱手术患者术中体感诱发电位(SEP)和运动诱发电位(MEP)监测的影响。总共36例在全身麻醉下接受脊柱手术的患者被随机分为两组(每组n = 18),C组为试验组,D组为对照组,两组均进行匹配的麻醉诱导。简而言之,通过注射依托咪酯和芬太尼给药麻醉;患者失去意识后,插入喉罩气道(LMA),监测SEP和MEP,并将收集的数据视为基础数据。随后注射顺式阿曲库铵并插入气管导管(7#)以替换LMA。进行以下麻醉维持程序:C组,通过依托咪酯靶控输注和芬太尼间断注射维持麻醉;D组,在10分钟内注射DEX(0.5μg/kg),然后以0.5μg/kg/h的速率泵注。两组中使用的所有其他药物相同,且未给予肌肉松弛剂。手术期间脑电双频指数维持在45至55之间,持续监测SEP和MEP直至手术完成。C组和D组之间SEP(P15 - N20)的持续时间和波幅无显著差异(P>0.05)。此外,在两组特定时间监测MEP,两组之间未观察到显著差异(P>0.05)。在脊柱手术期间接受DEX - 依托咪酯 - 芬太尼联合麻醉的患者中,SEP和MEP得以维持。

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