体感诱发电位与数量化脑电图监测地氟醚全身麻醉深度的临床研究

Clinical research on SEP and QEEG for monitoring the depth of desflurane anesthesia

目的探讨地氟醚吸入全身麻醉时上肢短潜伏期体感诱发电位(short latency somatosensory evokedpotentials,SL-SEP)、数量化脑电图(quantitative electroencephalography,QEEG)的变化。方法选择全麻患者30例,麻醉诱导后吸入地氟醚,依次维持呼末地氟醚浓度在0.4MAC、0.7MAC、1.0MAC、1.3MAC;分别记录麻醉过程中平均动脉压(MAP)、心率(HR)、QEEG(BIS、95%SEF、MF)和SL-SEP(LP15、LN20、LN11、AMPP15-N20、AMPN11、CCT)。结果患者HR、MAP以及皮层下电位N11的变化与吸入地氟醚浓度无明显量效关系(P>0.05);而QEEG值随吸入地氟醚的呼末浓度增高而降低(P<0.05);LP15、LN20和CCT随地氟醚呼气末浓度的增加而逐渐延长(P<0.05)。结论LP15、LN20、CCT以及QEEG各参数是监测地氟醚麻醉深度的较好指标。

[Objective] To evaluate the alteration of quantitative electroencephalography （QEEG） and somatosensory evoked potentials（SEP）in desflurane anesthesia. [Methods] Thirty patients undergoing general anesthesia were selected. The mean arterial blood pressure （MAP）, heart rate （HR）, QEEG（BIS, 95%SEF, MF） and SL-SEP （LP15, LN30, LN11, AMPp15-N30, AMPN11, CCT）were respectively recorded at end-tidal concentration of desflurane 0.4MAC, 0.7MAC, 1.0MAC and 1.3MAC. [Results] There were no significant change of MAP, HR and P15-N30, Nll in the group （P 〉0.05）. The latency of of P15, N20and CCT were significantly prolonged with the increase of end-tidal coneentration of desflurane （P 〈0.05）. Increasing in the end-tidal concentration of desflurane was associated with the graded reduction of QEEG （P 〈0.05）. [Conclusions] The P15, N30, CCT and QEEG are sensitive to monitor the depth of desflurane anesthesia.