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可乐定:异氟烷-氧化亚氮/氧气松弛麻醉的辅助用药。对脑电图功率谱、体感诱发电位和听觉诱发电位的影响。

Clonidine: an adjunct in isoflurane N2O/O2 relaxant anaesthesia. Effects on EEG power spectra, somatosensory and auditory evoked potentials.

作者信息

Gabriel A H, Faryniak B, Sojka G, Czech T, Freye E, Spiss C K

机构信息

Department of Anesthesia and General Intensive Care, University of Vienna, Austria.

出版信息

Anaesthesia. 1995 Apr;50(4):290-6. doi: 10.1111/j.1365-2044.1995.tb04601.x.

Abstract

We investigated the effect of clonidine in 19 patients having lumbar disc surgery under nitrous oxide/isoflurane/relaxant anaesthesia. The EEG, spinal and cortical somatosensory evoked potentials, and the brainstem auditory evoked potentials were recorded. After equilibration of the general anaesthetic, two successive infusions of clonidine (5 micrograms.kg-1) were given. After the second infusion of clonidine, the plasma concentration increased from 0.2(SEM 0.05) to 6.4(SEM 0.06) ng.ml-1 (p < 0.05). In the EEG, delta-activity was maintained, but the beta-fraction, and the 95% and 50% spectral frequencies were reduced. Total EEG power progressively decreased from 296(152-397) microV2 to 108(51-240) microV2. The somatosensory evoked spinal potential (N13) decreased in amplitude, (1.77(SEM 0.35) microV to 1.59(SEM 0.35) microV, p < 0.05) and increased in latency (14.37(SEM 0.29) ms to 14.69(SEM 0.31) ms, p < 0.05). The central conduction time increased from 6.47(SEM 0.16) ms to 6.92(SEM 0.25) ms, ns. There was no effect on the cortical somatosensory potentials, or the brainstem auditory evoked potentials. According to the EEG spectral indices, anaesthesia appeared to deepen despite a reduction in the end expiratory isoflurane concentration from 0.53(SEM 0.07) to 0.28(SEM 0.06) vol%, which indicated a reduction in anaesthetic requirements following clonidine.

摘要

我们研究了可乐定对19例在氧化亚氮/异氟烷/肌肉松弛剂麻醉下接受腰椎间盘手术患者的影响。记录了脑电图(EEG)、脊髓和皮质体感诱发电位以及脑干听觉诱发电位。在全身麻醉达到平衡后,连续两次输注可乐定(5微克/千克)。第二次输注可乐定后,血浆浓度从0.2(标准误0.05)升高至6.4(标准误0.06)纳克/毫升(p<0.05)。在脑电图中,δ波活动得以维持,但β波成分以及95%和50%频谱频率降低。脑电图总功率从296(152 - 397)微伏²逐渐降至108(51 - 240)微伏²。体感诱发电位脊髓电位(N13)幅度降低(从1.77(标准误0.35)微伏降至1.59(标准误0.35)微伏,p<0.05),潜伏期延长(从14.37(标准误0.29)毫秒增至14.69(标准误0.31)毫秒,p<0.05)。中枢传导时间从6.47(标准误0.16)毫秒增至6.92(标准误0.25)毫秒,无统计学意义。对皮质体感诱发电位或脑干听觉诱发电位无影响。根据脑电图频谱指数,尽管呼气末异氟烷浓度从0.53(标准误0.07)体积%降至0.28(标准误0.06)体积%,但麻醉似乎加深,这表明可乐定输注后麻醉需求降低。

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