Newlon P G, Greenberg R P, Enas G G, Becker D P
Neurosurgery. 1983 Jun;12(6):613-9. doi: 10.1227/00006123-198306000-00003.
We sought to determine whether pentobarbital (PB) coma compromises the use of evoked potentials (EPs) in the assessment of brain dysfunction and of the prognosis of severely head-injured patients. Therefore, the effects of therapeutic PB on somatosensory (SEPs, BSEPs), visual (VEPs), and auditory (BAEPs) evoked potentials recorded from 20 patients early after injury were analyzed. Seventeen head-injured patients served as controls. EP studies were obtained shortly after admission (Mean Day 2, PB present) and approximately 2 weeks after injury (Mean Day 15, PB absent). The mean serum level of PB in the treatment group was 1.9 mg/100 ml. The drug effect was assessed by comparisons between the PB and the control groups. Statistical analyses were based on differences observed between two studies in the same patient. Analyses of covariance (F tests) were performed on data from all modalities. Wave form complexity was minimally affected by the drug. Middle and long latency components of the SEP were depressed by PB, and latencies of BSEP peaks and the early components of the SEP were delayed. The amplitude of some VEP peaks was reduced by PB. The BAEP was not significantly altered. All of the observed effects of PB were determined to be due to the hypothermia exhibited by PB-treated patients (mean temperature, 36.1 degrees C), which was not seen in the control group (mean, 37.8 degrees C). It is concluded that, with appropriate interpretation, EPs can be used to monitor brain function in head-injured patients when PB therapy is used.
我们试图确定戊巴比妥（PB）昏迷是否会影响诱发电位（EPs）在评估脑功能障碍和重型颅脑损伤患者预后中的应用。因此，分析了治疗性PB对20例患者伤后早期记录的体感诱发电位（SEPs、BSEPs）、视觉诱发电位（VEPs）和听觉诱发电位（BAEPs）的影响。17例颅脑损伤患者作为对照。在入院后不久（平均第2天，使用PB）和伤后约2周（平均第15天，未使用PB）进行EP研究。治疗组PB的平均血清水平为1.9mg/100ml。通过比较PB组和对照组来评估药物效果。统计分析基于同一患者两次研究中观察到的差异。对所有模式的数据进行协方差分析（F检验）。波形复杂性受药物影响最小。PB使SEP的中、长潜伏期成分降低，BSEP峰潜伏期和SEP早期成分延迟。PB使一些VEP峰的振幅降低。BAEP无明显改变。确定PB的所有观察到的效应是由于PB治疗患者表现出的体温过低（平均体温36.1摄氏度），而对照组未见此情况（平均体温37.8摄氏度）。结论是，经过适当解读，在使用PB治疗时，EPs可用于监测颅脑损伤患者的脑功能。
