不同麻醉方式的选择对颈椎手术中运动诱发电位监测的影响

Effects of different anaesthetic methods on motor evoked potentials monitoring during cervical spine surgery

目的探讨采用神经阻滞联合全身麻醉是否能够增加颈椎手术中运动诱发电位(MEP)的引出率。方法选择2015年1月至6月择期行颈椎减压内固定手术患者50例,随机分为2组(神经阻滞复合全麻组和全麻组),比较两组间术中运动诱发电位(MEP)的引出率是否存在差异。结果神经阻滞复合全麻组在术中引出率较高,神经阻滞复合全麻组中MEP波幅出现的阳性率为80%(20/25),而全麻组中MEP波幅出现的阳性率仅为44%(11/25),N组的MEP诱出率显著高于全麻组,两组之间有统计学意义(P<0.05)。结论在手术前采用神经阻滞麻醉后再行常规全身麻醉,可使术中引出MEP百分率较高,监护脊髓损伤记录更加的可靠,可能的原因在于神经阻滞减少了术中麻醉药物和肌松药物的使用,从而提高了MEP的引出率。

Objective To investigate the positive rate of MEP appearance in the anaesthetic method of nerve block associated with general anaesthesia. Methods Fifty patients undergoing anterior cervical decompression were included in this study from January to June in 2015. Patients were randomly divided into nerve block associated with general anaesthesia group and general anaesthesia group. The positive rates of MEP appearance during surgery were recorded and compared between two groups. Results The positive rate of MEP appearance in nerve block associated with general anaesthesia group was 80% （20/25） ,which was significantly higher than that of 44% （11/25） in general anaesthesia group （P〈0.05）. Conclusion The anaesthetic method of nerve block associated with general anaesthesia can increase the positive rate of MEP appearance during cervical surgery,which may be caused by the reduced use of anaesthetic drugs.