不同剂量异丙酚、咪唑安定和依托咪酯对上肢短潜伏期体感诱发电位的影响

观察3组不同剂量静脉麻醉药异丙酚、咪唑安定、依托咪酯对上肢短潜伏期体感诱发电位(SLSEP)影响。方法:90例择期手术患者,随机分成3组,每组再随机分为3个不同剂量组.分别单次静脉注射异丙酚1.5、2、3mg/kg,咪唑安定0.2、0.3、0.4mg/kg,依托咪酯0.15、0.3、0.4mg/kg,观察用药后对SLSEP的影响。结果:异丙酚组均对SLSEP的N_14、N_20潜伏期和CCT无明显影响,但使N_20-P_25波幅显著性抑制,该作用在用药后10分钟恢复。咪唑安定组均使N_20潜伏期和CCT显著延长,且在病人苏醒后仍未恢复,对N_(14)潜伏期无影响,N_(20)-P_(25)波幅出现明显下降。依托咪酯组出现N_(20)-P_(25)波幅明显增大,且在病人苏醒后仍未降至基础值,对潜伏期的影响与咪唑安定类似。结论:依托咪酯较适合术中行诱发电位监护时应用。

Effect of propofol,midazolam and etomidate on short latency somatosensory evoked potential

Objective: To study the effect of three different doses of propofol, midazolam and etomidate on short latency somatosensory evoked potential(SLSEP). Method:Ninety patients undergoing elective operation were randomly divided into 3 groups with 3 subgroups each,and propofol,midazolam,etomidate were administered by bolus injection at propofol 1.5,2,3mg/kg, midazolam 0.2,0.3,0.4mg/kg, etomidate 0.15,0.3,0.4mg/kg accordingly. SLSEP was recorded before,during and after injection. Result:Propofol did not significantly change the latencies of the subcortical N_(14),cortical N_(20) and central conduction time(CCT)N_(14)-N_(20),decreased the interwave amplitude N_(20)-P_(25)(P<0.05),the decrease recovered in 10 minute after injection. Midazolam significantly prolonged the latencies of the cortical potential N_(20) and CCT except for N_(14),the changes did not recovered when the patients had opened their eyes,it also decreased amplitude of N_(20)-P_(25). Etomidate significantly increased both the amplitude of N_(20)-P_(25) and the latencies of N_(20) and CCT,but did not affect the latency of N_(14). Conclusion:Etomidate may be the most suitable drug among these three drugs during operative monitoring with SLSEP.