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急性低碳酸血症对人正中神经体感诱发电位的影响。

The effect of acute hypocapnia on human median nerve somatosensory evoked responses.

作者信息

Schubert A, Drummond J C

出版信息

Anesth Analg. 1986 Mar;65(3):240-4.

PMID:3082246
Abstract

This study was undertaken to define the effect of acute hypocapnia on intraoperatively recorded somatosensory evoked potentials (SSEPs). Median nerve SSEPs were studied in ten anesthetized neurologically normal adult patients undergoing elective nonneurologic surgery. End-tidal carbon dioxide tension (ETCO2) was allowed to stabilize for 15 min before SSEP recordings were obtained during normocapnia (N) (ETCO2 = 39.9 +/- 1.45 mm Hg), hypocapnia (H) (ETCO2 = 20.6 +/- 1.07 mm Hg), and after return to normocapnia (NR). Although a trend toward a reduction in the latencies of all SSEP components was evident, only the cervical (CII), and cortical (N1 and P1) latencies decreased significantly with H when compared to N. Mean latencies for CII, N1, and P1 (+/- SD) were, respectively, 14.80 +/- 1.14, 20.93 +/- 1.50, and 25.17 +/- 2.88 msec during N, and 14.50 +/- 1.13, 20.25 +/- 1.49, and 24.23 +/- 2.52 msec during H. On return to normocapnia, latencies were unchanged from N. Cortical latencies were affected to a greater extent than subcortical ones. Aside from a small but statistically significant increase in CII amplitude at H (2.05 +/- 0.55 microV vs 1.83 +/- 0.49 microV at N), SSEP amplitudes were unaffected by hypocapnia. The authors conclude that acute hypocapnia in neurologically normal patients results in a small reduction of SSEP latencies. The magnitude of the change is such that it is unlikely to interfere with recording or interpretation of intraoperative SSEPs.

摘要

本研究旨在确定急性低碳酸血症对术中记录的体感诱发电位(SSEPs)的影响。对10例接受择期非神经外科手术的麻醉状态下神经系统正常的成年患者进行了正中神经SSEPs研究。在正常碳酸血症(N)(呼气末二氧化碳分压[ETCO2]=39.9±1.45mmHg)、低碳酸血症(H)(ETCO2=20.6±1.07mmHg)以及恢复至正常碳酸血症(NR)后,在获取SSEP记录前,使呼气末二氧化碳分压稳定15分钟。尽管所有SSEP成分的潜伏期有缩短趋势,但与N相比,仅在H时颈段(CII)以及皮层(N1和P1)潜伏期显著缩短。N时CII、N1和P1的平均潜伏期(±标准差)分别为14.80±1.14、20.93±1.50和25.17±2.88毫秒,H时分别为14.50±1.13、20.25±1.49和24.23±2.52毫秒。恢复至正常碳酸血症时,潜伏期与N时无变化。皮层潜伏期比皮层下潜伏期受影响程度更大。除了在H时CII波幅有小幅度但具有统计学意义的增加(2.05±0.55微伏 vs N时的1.83±0.49微伏)外,SSEP波幅不受低碳酸血症影响。作者得出结论,神经系统正常患者的急性低碳酸血症会导致SSEP潜伏期小幅缩短。这种变化幅度不大可能干扰术中SSEPs的记录或解读。

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