地氟醚麻醉下诱发电位监测意识与疼痛的临床研究

Evoked potentials monitor consciousness and analgesia during desflurane anesthesia

目的 地氟醚麻醉下诱发电位 (EP)监测意识与镇痛的可行性研究 ,观察麻醉剂用量及麻醉后苏醒情况 .方法 2 0例择期全麻手术患者随机分为 2组 ,诱导后地氟醚 +N2 O维持麻醉 ,监测 EP,实验组调整麻醉剂量使体感诱发电位P1 5 - N2 0 波幅维持在 0 .2 8μV和听觉诱发电位 Nb潜伏期维持45 ms,对照组根据临床经验调整麻醉剂量 .结果 对照组显著 P1 5 - N2 0 波幅压低和 Nb潜伏期延长 .实验组呼气末地氟醚浓度显著降低和地氟醚用量减少 ,麻醉后苏醒显著加快 .结论 EP监测指导吸入麻醉具有很好的应用价值 。

AIM To assess the effect of evoked potential (EP) monitoring on the utilization of desflurane and their recovery profiles after anesthesia. METHODS Twenty patients undergoing elective general anesthesia surgery operations were randomly divided into two groups. After induction, anesthesia was maintained with desflurane and N 2O. In control group the anesthetists were blind to the evoked potential display, and the anesthetics were administered according to standard clinical practice. In EP-guided group, the anesthetics were adjusted to maintain P 15 -N 20 amplitude at0.28 μV and Nb latency at 45 ms. RESULTS During the maintenance period the P 15 -N 20 amplitude significantly decreased and the Nb latency significantly increased in the control group. In the EP-guided group the desflurane usage was lower and the time of recovery shorter compared with the control group. CONCLUSION EP monitor during desflurane and N 2O anesthesia can decrease the amount of desflurane needs and contribute to fast recovery after anesthesia.