丙泊酚单独或联合芬太尼静脉注射对运动诱发电位效应的比较.docVIP

丙泊酚单独或联合芬太尼静脉注射对运动诱发电位效应的比较 　 广州医学院第一附属医院麻醉科（张兴洁、余革、杨凤泉、郑则广、陈荣昌）；510120 广州医学院附属广州巿第一人民医院麻醉科（佘守章） 510180 张兴洁　余革　佘守章　杨凤泉　郑则广　陈荣昌 【摘要】　目的　比较同等剂量的丙泊酚单独或联合芬太尼单次静脉注射对骨骼肌运动诱发电位（MEP）的影响。方法　选择ASAⅠ～Ⅱ级的择期手术患者11例，对第六颈椎(C6)实施磁刺激，记录拇短展肌的MEP。实验一，静脉注射丙泊酚（2mg/kg），注射时间为30s，从注药开始每20s记录一次MEP至患者清醒。实验一注药后30 min进行实验二，静脉注射丙泊酚（2mg/kg）和芬太尼（5μg/kg），注射时间为60s（每药30s），再次记录患者的MEP，记录时间为360s。结果　两实验注药后MEP的波幅均出现一个先下降后回升的趋势，下降的最低值均比注药前的基础值低（P0.01），两实验的最后观察值也低于基础值（P0.01）。两实验注药前MEP波幅的基础值间无统计学差异（P0.05），注药后MEP波幅下降的最低值间无统计学差异（P0.05），但实验二MEP波幅的最后值比实验一的低（P0.05）。两实验各个时点MEP的潜伏期均无变化（P0.05）。结论　丙泊酚单次静脉注射对颈部磁刺激诱发的拇短展肌MEP波幅有抑制作用；丙泊酚联合芬太尼单次静脉注射，芬太尼可增强丙泊酚对拇短展肌MEP波幅的抑制作用。 【关键词】 运动诱发电位　拇短展肌　磁刺激　丙泊酚　芬太尼 A comparison of the effects on motor evoked potentials by intravenous injection of a bolus of propofol given solely or with fentanyl　Zhang Xing-jie*, YU Ge, SHE Shou-zhang,et al. *Department of Anesthesiology, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou, 510120，China 【Abstract】 Objective To compare the influences of skeleton muscle Motor Evoked Potentials (MEPs) by a bolus injection of propofol singly or combined with fentanyl. Methods Eleven ASA Ⅰ or Ⅱ patients scheduled for elective surgeries were enrolled in this study. Magnetic stimuli were delivered to the 6th cervical vertebra (C6), and the evoked MEPs of abductor pollicis brevis were recorded. Test one: propofol was infused intravenously by 30 seconds, and the MEPs were obtained from the very beginning of the injection till the patients became consciousness. Thirty minutes after the injection of test one, go on test two. A combination of propofol 2mg/kg and fentanyl 5μg/kg was infused. The infusing time was 60 seconds (30 seconds for each). Record the MEPs every 20 seconds as test one. The recording time was 360 seconds. Results Amplitudes of MEPs descended and then recovered after the injections in both tests, with the minimal values were lower than baselines（P0.01）,and the final values were lower than baselines, too（P0.01）. The bas