吸入不同浓度异氟醚对喉返神经肌电活动的影响

The effects of different concentration of isoflurane inhalation on electromyography of recurrent laryngeal nerve

目的观察不同浓度的异氟醚吸入对喉返神经肌电活动的影响。方法30例择期甲状腺手术患者,ASAⅠ～Ⅱ级,采用异氟醚吸入复合静脉麻醉。于分离甲状腺前诱导恢复自主呼吸,调整异氟醚呼出浓度为0.1、0.2、0.3、0.4、0.5、0.6、0.7MAC时,观察血压、心率及喉返神经肌电活动波的振幅变化,记录喉返神经肌电波形振幅等于100μV时的异氟醚呼出浓度。结果当异氟醚呼出浓度为0.1、0.2、0.3、0.4MAC时,喉返神经肌电活动显示良好,当异氟醚呼出浓度为0.5、0.6、0.7MAC时,喉返神经肌电活动振幅降低,随异氟醚吸入浓度增高直至消失。结论低浓度异氟醚吸入,基本不会影响喉返神经功能的监控。

Objective To observe the effects of different concentration of isoflurane inhalation on electromyography（EMG） of the recurrent laryngeal nerve. Methods Thirty ASA Ⅰ -Ⅱ patients with thyroid gland surgery were given different concentration of isoflurane inhalation combined with propofol infusion. BP, HR and EMG of recurrent laryngeal nerve were recorded when the concentrations of isoflurane inhalation were at 0.1,0.2,0. 3,0. 4,0.5,0.6 and 0. 7 MAC. Results The function of the recurrent laryngeal nerve was normal when the end tidal concentration of isoflurane was at 0.1, 0.2,0.3 or 0.4 MAC. The amplitude of the recurrent laryngeal decreased during general anesthesia when the end tidal concentration of isoflurane was at 0.5,0.6 or 0.7 MAC. Conclusion Low concentration of isoflurane inhalation can not inhibit the action potential of the recurrent laryngeal nerve.