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[脊柱手术中的神经监测与麻醉]

[Neuromonitoring and anesthesia in surgery of the spine].

作者信息

Laureau E, Marciniak B, Hebrard A, Herbaux B, Guieu J D

机构信息

Service de neurophysiologie clinique, CHRU Lille, France.

出版信息

Neurophysiol Clin. 1998 Sep;28(4):299-320. doi: 10.1016/s0987-7053(98)80002-6.

Abstract

The authors report the main effects of anaesthetic drugs that are used alone or in association with anaesthetic protocols on somatosensory evoked potentials (SEP) and on motor evoked potentials (MEP). In the first part of the article, the effects are analysed on SEPs and MEPs that are obtained from non-invasive methods; in the second part, the effects of anaesthesia are analysed with respect to invasive methods of EP recordings. The current increase of invasive techniques of neuromonitoring by SEPs and MEPs is in relation with the weak effect of anaesthetics on evoked responses. Total intravenous anaesthesia (TIVA) provides stable anaesthesia for non-invasive SEP neuromonitoring only if bolus is avoided. With TIVA and other anaesthetic techniques, the introduction of repetitive stimulation provides new possibilities for non-invasive MEP neuromonitoring.

摘要

作者报告了单独使用或与麻醉方案联合使用的麻醉药物对体感诱发电位(SEP)和运动诱发电位(MEP)的主要影响。在文章的第一部分,分析了从非侵入性方法获得的SEP和MEP的影响;在第二部分,分析了麻醉对侵入性诱发电位记录方法的影响。目前通过SEP和MEP进行神经监测的侵入性技术的增加与麻醉剂对诱发反应的微弱影响有关。仅当避免推注时,全静脉麻醉(TIVA)才能为非侵入性SEP神经监测提供稳定的麻醉。对于TIVA和其他麻醉技术,重复刺激的引入为非侵入性MEP神经监测提供了新的可能性。

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