静脉普鲁卡因复合麻醉脑电图、脑诱发电位的监测研究

A STUDY OF THE MONITORING OF EEG AND BRAIN EVOKED POTENTIAL UNDER PROCAINE COMBINED ANESTHESIA

目的：普鲁卡因、氯胺酮、琥珀胆碱静脉复合全麻的脑电图（EEG）、脑干听党诱发电位（BAEP）、体感诱发电位（SEP）的监测研究。方法：对27例腹部或盆腔手术的病人分别进行麻醉前、诱导时、手术中1小时，投气管插管时和停药后1小时的EEG、SEP、BAEP的监测和描记。结果：EEG在麻醉诱导时是爆发性抑制，其等电位时间的长短与麻醉深度有关，麻醉中各时期SEP和N55、P80波潜伏期延长，P80波幅降低，BAEP的Ⅲ、Ⅴ波潜伏期延长；手术中亚小时Ⅰ～-Ⅴ波峰间期亦延长；P值均<0．05～0.01。BAEP在停药1小时后异常改变恢复到麻醉前水平，SEP未达到此结果．结论：静脉普鲁卡因复合麻醉主要作用于大脑皮层，似从额叶向全脑抑制，对脑干的桥脑，中脑也有一定抑制作用，但较大脑皮层轻。停药1小时陷干功能已基本恢复正常。试图用EEG的爆发性抑制的等电位时间的长短判断麻醉深度．

Objective: To study the monitoring of EEG,BAEP and SEP under procaine,ketamine and succinycholine combined general anesthesia. Methods:Recrds of EEG,SEP andBAEP of 27 patients,who were performed abdominal or pelvic operation,were made respectively before anesthesia,during induction period,one hour after commencement of the operation,at the extraction of tracheal cannula and one hour after withdrawal of medication. Results:EEG showed fulminating inhibition and its time lapse of isoelectric potentiaI seemed related with the depth of anesthesia. The latent period of N55 and P80 waves of the SEP prolonged during each period of anesthesia; P80 wave amplitude lowered; the Iatent period ofBANA t and V prolonged,the discontinuity of I ~ V wave crest prolonged, (P<0. 05~0.01) one hour after commencement of the operation. The abnormity of BAEP restored to thelevel before anesthesia at one hour after withdraw of medication. No such changes were seenin SEP and EEG. Concluslon:Intravenous procaine comdined anesthesia acts mainly on thecerebral cortex and it seems that the inhibition spreads from frontal lobe to the whole brain.It has inhibitive effect on the pons of the brain stem and midbrain,too,yet,not so much as onthe cerebral cortex. We tried to judge the depth of anesthesia by the time lapse of isoelectricpotential of EEC fulminating inhibition.