应用镇静药物的ICU病人在胸部物理治疗期间视觉诱发电位的变化

Changes of visual evoked potential in the sedated patients in the ICU during physiotherapy

目的：通过视觉诱发电位（ＶＥＰ）方法，来测定镇静深度的可行性。方法：７例应用镇静药和肌松药的ＩＣＵ病人在进行胸部物理治疗期间视觉诱发电位和血流动力学变化进行了测定。结果：在胸部物理治疗过程中，ＶＥＰ图形中Ｐ６０、Ｎ７５、Ｐ１００和Ｎ１２５的时限明显缩短（Ｐ＜０．０５）），如上各点的振幅及平均动脉压虽有上升的趋势，脉搏亦有增快的趋势，但无统计学意义（Ｐ＞０．０５））。结论：ＶＥＰ能够反映镇静病人在行胸部物理治疗期间其中枢神经系统的变化情况，可作为一种监测镇静深度的客观指标。

Objective:The visual evoked potential(VEP)was used to assess the depth of sedation in order to seek the feasibility of the VEP in measuring the depth of sedation in the ICU patients Methods:VEP was recorded in 7 cases before,during and after physiotherapy The patients were sedated with propofol and alfentinal,and paralyzed with atracurium ANOVA was used for comparing the data collected in the three periods Results:The latencies of P60,N75,P100 and N125 in the VEP waveform reduced significantly during the physiotherapy(P<0 05)and returned to the baseline after physiotherapy However the changes in the amplitude of those peeks,MAP and HR were not statistically significant as compared to the baseline Conclusion:The results suggest that VEP can detect the changes in the central nervous system during the physiotherapy and might be used as an indicator of depth of sedation