七氟醚和异丙酚对上肢体感诱发电位的影响

目的:比较全麻药物异丙酚和不同浓度的七氟醚对病人的体感诱发电位(SEP)监测结果的影响.方法:选取50例全麻手术病人,随机分为七氟醚(S)组30例和异丙酚(P)组20例.S组于诱导后吸入七氟醚,使肺泡内七氟醚浓度依次达到0.5、1.0、1.5 MAC,并分别将其作为观察点作SEP术中监测;P组于诱导后全凭静脉稳定泵入异丙酚,并分别将诱导后泵入前、泵入后15、30、45 min作为观察点作SEP术中监测.记录两组麻醉前及上述各时点的SEP波幅、潜伏期变化.结果:S组随着麻醉深度的改变和七氟醚浓度的增加,其SEP潜伏期明显延长,波幅明显下降,在各肺泡七氟醚浓度之间比较差异有极显著意义(P＜0.001).P组平稳麻醉各时点对SEP潜伏期及波幅的影响小,其间差异无统计学意义(P＞0.05).结论:麻醉时吸入性麻醉药物七氟醚对SEP波幅、潜伏期有明显影响,吸入浓度小于1.0 MAC时SEP较为稳定,麻醉效果较为理想;异丙酚全凭静脉麻醉对SEP影响较小.

Effects of sevoflurane and propofol upon the moritoring by SEP in operation

Objective:To compare the effects of sevoflurane of different concentrations and propofol upon the monitoring by short-latency somatosensory evoked potentials(SEP)in forearms in operation. Methods:50 intraoperative patients in anaethesia were randomly divided into two groups:S group and P group.In S group,after tracheal intubation,sevoflurane was inhaled and sevoflurane concentrations of intraalveoli reached to 0.5 MAC,1.0 MAC and 1.5 MAC in turn.In P group,propofol was used intra- venously,intravenous points of observation were respectively at the 15~(th),30~(th) and 45~(th) minute,Latency and amplitude of SEP were recorded in both groups.Results:With increasing concentrations of sevoflu- rane,there was a progressive increase in latency and decrease in amplitude(P<0.001)of SEP of the forearms.But propofol of intravenous guttae had no significant change(P>0.05).Conclusion:As sevoflurane inhaled concentration is lower than 1.0 MAC,the monitoring of SEP is rether stable,and the effect of anaethesia is desrable.Propofol of intravenous guttae have no significant effect on SEP.