脊柱侧弯矫形术中七氟烷联合丙泊酚静吸复合麻醉对SEP及MEP的影响

Effects of sevoflurane combined with propofol intravenous-inhalation anesthesia on SEP and MEP in patients with scoliosis correction surgery

目的探索脊柱侧弯矫形术中七氟烷联合丙泊酚静吸复合麻醉对体感诱发电位(somatosensory evoked potential,SEP)及运动诱发电位(motor evoked potential,MEP)的影响,并对2种麻醉方式效果进行评估,为七氟烷联合丙泊酚静吸复合麻醉提供临床参考。方法选取2013年1月—2016年1月收治的青少年患者共60例,患者均需要采用脊柱侧弯矫形术进行矫正,按照随机数字表法随机分为A组(丙泊酚全凭静脉麻醉组)和B组(七氟烷-丙泊酚静吸复合麻醉组)各30例,比较2组患者一般情况(体重、手术时间、出血量)、血流动力学(患者各时点心率、各时点动脉压)、体感诱发电位、运动诱发电位成功率以及睁眼、拔管时间,使用SPSS 19.0统计学软件,2组比较采用独立样本t检验进行数据比较分析。结果 2组患者手术时间(t=0.15,P=0.87)、出血量(t=0.33,P=0.74)、MEP成功率(t=0.00,P=1.00)、SEP成功率(t=0.00,P=1.00)相比,差异无统计学意义(P>0.05);术后B组较A组睁眼时间(t=4.47,P=0.00)、拔管时间缩短(t=3.60,P=0.00),差异有统计学意义(P<0.05)。结论七氟烷-丙泊酚静吸复合麻醉用于脊柱侧弯矫形术,患者术后苏醒快,可能更利于术后神经功能的评估。

Objective To explore the effects of sevoflurane combined with propofol intravenous-inhalation anesthesia on somatosensory evoked potential（SEP） and motor evoked potential（MEP） in patients with scoliosis correction surgery and compared with the propofol intravenous anesthesia. Methods Total 60 cases of adolescent idiopathic scoliosis with scolio- sis correction surgery in our hospital from January, 2013 to January, 2016 were recruited and randomly divided into group A（ propofol intravenous anesthesia） and group B（ sevoflurane combined with propofol intravenous-inhalation anesthesia） with 30 cases in each group. The general condition （weight, operative time, bleeding loss volume）, hemodynamics parame- ters （heart rate and arterial pressure at each time point）, success rate of SEP and MEP, as well as the time to anesthetic awareness and extubation were recorded. The independent - samples T test was performed for data comparison and analy- sis by SPSS 19.0. Results There were no statistical difference in the operation time （ t = 0.15, P = 0.87 ）, blood loss （ t = 0.33 ,P =0.74） ,success rate of MEP（t =0.00,P = 1.00） and SEP（t = 0.00,P = 1.00） between the two groups. The time to anesthetic awareness（ t = 4.47 ,P = 0.00） and extubation（ t = 3.60 ,P = 0.00） in group B were shorter than those in the group A. Conclusion The patients undergoing sevoflurane combined with propofol intravenous-inhalation anesthe- sia during scoliosis correction surgery may recovery from anesthetic quickly, which is beneficial to the evaluation of the postoperative neurological function.