McPherson R W, Sell B, Traystman R J
Anesthesiology. 1986 Dec;65(6):584-9. doi: 10.1097/00000542-198612000-00004.
The effects of three anesthetic induction agents on somatosensory evoked potentials (SEP) were assessed in unpremedicated patients who were without neurologic abnormality of the upper extremities. SEP was assessed by stimulation of the nondominant median nerve and responses were recorded over Erbs point (N10), second cervical vertebra (N14), and the contralateral cortex (P15, N20, P23 latencies, and P15-N20 and N20-P23 amplitudes). Nine patients received thipental (4 mg/kg, iv bolus), nine patients received fentanyl (25 micrograms/kg, iv bolus), and nine patients received etomidate (0.4 mg/kg, iv bolus). SEP was assessed before and after drug administration at motor threshold stimulus intensity. Thiopental increased the latency of N10, N14, and N20. The amplitudes of N10-, N14-, and scalp-recorded waves were not altered by thiopental. Fentanyl increased N20 and P23 latency and decreased the amplitude of P15-N20. Etomidate increased latency of N20 and P23 without alteration of latencies of N10 or N14 and increased the amplitude of P15-N20 and N20-P23, while the amplitude of N10 was unchanged and the amplitude of N14 was decreased. It is concluded that thiopental or fentanyl causes only modest alterations in early waves of upper extremity SEP, whereas etomidate increases the amplitude of scalp-recorded waves. The effect of etomidate on SEP may make diagnosis of neurologic injury more difficult because of the changing waveform.
在未使用术前药且上肢无神经功能异常的患者中，评估了三种麻醉诱导药物对体感诱发电位（SEP）的影响。通过刺激非优势正中神经来评估SEP，并在Erb点（N10）、第二颈椎（N14）和对侧皮层（P15、N20、P23潜伏期以及P15 - N20和N20 - P23波幅）记录反应。9例患者接受硫喷妥钠（4mg/kg，静脉推注），9例患者接受芬太尼（25μg/kg，静脉推注），9例患者接受依托咪酯（0.4mg/kg，静脉推注）。在运动阈值刺激强度下，于给药前后评估SEP。硫喷妥钠增加了N10、N14和N20的潜伏期。硫喷妥钠未改变N10、N14以及头皮记录波的波幅。芬太尼增加了N20和P23的潜伏期，并降低了P15 - N20的波幅。依托咪酯增加了N20和P23的潜伏期，但未改变N10或N14的潜伏期，同时增加了P15 - N20和N20 - P23的波幅，而N10的波幅未变，N14的波幅降低。结论是硫喷妥钠或芬太尼仅引起上肢SEP早期波的适度改变，而依托咪酯增加了头皮记录波的波幅。依托咪酯对SEP的影响可能会因波形变化而使神经损伤的诊断更加困难。
