手术时间对俯卧位脊柱手术患者闪光视觉诱发电位的影响

Effects of duration of surgery on flash-induced visual evoked potentials in patients undergoing spinal sur gery in prone position

目的探讨手术时间对俯卧位脊柱手术患者闪光视觉诱发电位的影响。方法择期行俯卧位脊柱后路手术患者82例，性别不限，年龄20～76岁，体重43～96kg，ASA分级I或Ⅱ级，按照手术时间分为3组：手术时间≤2h组（s组，n=34）；2h〈手术时间〈4h组（M组，n=38）；手术时间≥4h组（L组，n=10）。术中采取全凭静脉麻醉。采用protektor视觉诱发电位监测仪监测视觉诱发电位。分别于麻醉前、麻醉后10min和术毕时，记录P100波的潜伏期、波幅和潜伏期恢复至麻醉前水平的时间（恢复时间）。结果与S组比较，M组术毕时波幅降低，L组术毕时潜伏期延长，波幅降低（P〈0．05）；与M组比较，L组术毕时潜伏期延长，波幅降低（P〈0．05）。与s组和M组比较，L组恢复时间延长（P〈0．01）；S组与M组恢复时间比较差异无统计学意义（P〉0．05）。结论时间〉／4h的俯卧位脊柱手术可影响患者的闪光视觉诱发电位。

Objective To investigate the effects of duration of surgery on flash-induced visual evoked po- tentials （VEP） in patients undergoing spinal surgery in prone position. Methods Eighty-two ASA I or H pa- tients of both sexes aged 20-76 yr weighing 43-96 kg undergoing spinal surgery in prone position were divided into 3 groups according to the duration of surgery： group S≤2 h （ n = 34） ; group M 2-4 h （ n = 38） and group L≥4 h （ n = 10）. VEP was monitored using protektor VEP monitoring device （Xltek Co., Canada）. The latency, amplitude and recovery time of wave P100 were recorded before and 10 rain after induction of anesthesia and at the end of surgery. Results Compared with group S, the amplitude of wave P100 was significantly decreased at the end of surgery in group M, the lantency of wave P100 was significantly prolonged, while the amplitude of wave P100 was decreased at the end of stffgery in group L （P 〈 0.05）. Compared with group M, the lantency of wave P100 was significantly prolonged, while the. amplitude of wave P100 was decreased at the end of surgery in group L （P 〈 0.05）. Compared with groups S and M, the recovery time of wave P100 was significantly prolonged in group L （ P 〈 0.05）. There was no significant difference in the recovery time of wave P100 between groups S and M （ P 〉 0.05）. Conclusion Duration of surgery （ t〉 4 h） can affect flash-induced VEP, the longer the duration, the stronger the effects.