体感诱发电位N20波能否反映全麻中的镇痛成份

Does the Change of Wave N20 of Somatosensory Evoked Potentials Reflect the Analgesic Component of Anesthesia

目的：比较非镇痛性麻醉药异丙酚与镇痛性麻醉药芬太尼对上肢短潜伏期体感诱发电位（ＳＬＳＥＰ）Ｎ２０波影响的差异。方法：２０例择期全麻手术患者依异丙酚和芬太尼的给药顺序不同分为两组监测ＳＬＳＥＰＮ２０波的变化。结果：异丙酚使Ｎ２０波潜伏期显著延长，波幅显著升高。芬太尼对Ｎ２０波潜伏期及波幅均无显著影响。异丙酚芬太尼复合使用时Ｎ２０波潜伏期显著延长，波幅则无明显改变。结论：ＳＬＳＥＰＮ２０波不能反映全麻中的镇痛成份。异丙酚静脉麻醉适于需用ＳＥＰ监测感觉传导通路完整性的手术时的麻醉。

Objective: To study the different effects of propofol and fentanyl on wave N20 of short latency somatosensory evoked potentials. Methods: Twenty patients undergoing elective general anesthesia surgery were divided into two groups according to the different order of the two drugs administered. The changes of the wave N20 were observed by Axon System Sentine14 Neurologic monitor. Results: Propofol significantly increased both the latency and the amplitude of the wave N20, but fentany1 did not. Combination of propofol and fentany1 increased the latency, but had no significant effects on the amplitude of the wave N20. Conclusion: The somatosensory evoked wave N20 does not reflect the analgesic component of anesthesia. Introvenous propofol anesthesia may be suitable when somatosensory path ways monitoring with somatosensory evoked potentials is necessary.