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[外周肌肉松弛剂引入后脑电图和心电图可能出现的变化]

[Possible changes in the electroencephalogram and electrocardiogram after the introduction of peripheral muscle relaxants].

作者信息

Mikhailov A Yu, Berezina I Yu, Sumsky L I, Arzumanov Yu L

机构信息

Serbsky Federal Medical Research Centre for Psychiatry and Narcology, Moscow, Russia.

Davydovsky City Clinical Hospital, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(3):104-109. doi: 10.17116/jnevro2023123031104.

Abstract

OBJECTIVE

To evaluate the changes in the electroencephalogram (EEG) parameters in time, coinciding with the changes recorded by the electrocardiogram (ECG) channel in patients after the introduction of peripheral muscle relaxants.

MATERIAL AND METHODS

Twenty-four patients were examined in intensive care units on artificial lung ventilation (ALV). During the study, myographic artifacts were recorded in all patients in the EEG, the elimination of which was impossible without the use of pharmacological agents leading to relaxation of muscles - muscle relaxants of peripheral action.

RESULTS

Complete suppression of myographic artifacts on the EEG was noted in all patients after the introduction of peripheral muscle relaxants. However, in 4 of them, EEG changes were noted in the period 2 to 3 minutes after the introduction of muscle relaxants and the disappearance of myographic artifacts on the EEG. These changes coincided in time with the changes recorded by the ECG channel.

CONCLUSIONS

The EEG changes in time, coinciding with the changes in ECG indicators, suggest the presence of short-term disturbances of the functional state of the basic brain systems, probably due to changes in hemodynamics due to cardiac rhythm and conduction disturbances. It is advisable to record the EEG with the inclusion of an ECG channel in the wiring diagram for synchronous recording.

摘要

目的

评估在使用外周肌肉松弛剂后,患者脑电图(EEG)参数随时间的变化情况,这些变化与心电图(ECG)通道记录的变化相符。

材料与方法

在重症监护病房对24例接受人工肺通气(ALV)的患者进行检查。在研究过程中,所有患者的脑电图中均记录到肌电图伪迹,若不使用导致肌肉松弛的药物——外周作用的肌肉松弛剂,就无法消除这些伪迹。

结果

在使用外周肌肉松弛剂后,所有患者的脑电图上肌电图伪迹均被完全抑制。然而,其中4例患者在使用肌肉松弛剂后2至3分钟,脑电图出现变化,且脑电图上肌电图伪迹消失。这些变化在时间上与心电图通道记录的变化相符。

结论

脑电图随时间的变化与心电图指标的变化相符,提示大脑基本系统功能状态存在短期紊乱,可能是由于心律和传导紊乱导致血流动力学变化所致。建议在同步记录的布线图中纳入心电图通道来记录脑电图。

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