术前服用硝苯地平对吸入七氟醚麻醉中体感诱发电位监测的影响

Effects of using nifedipine preoperative during sevoflurane anesthesia on somatosensory evoked potentials

目的研究术前含服硝苯地平对吸入七氟醚麻醉中体感诱发电位(SEP)监测的影响。方法 30例ASAⅠ～Ⅱ级Ⅱ期高血压患者,术前SEP检查无异常,随机分为两组,术前1hA组舌下含服硝苯地平片,B组舌下含服淀粉片。入室后常规快速诱导。维持用药:吸入七氟醚,使吸入浓度分别达到0.5、1.0、1.5MAC,并维持15min,观察记录并比较两组患者间血压、心率的变化以及P15、N20、P25波的潜伏期和P15-N20、N20-P25波幅的改变。结果术前含服硝苯地平组插管期MAP明显低于对照组(P<0.05),诱导后两组患者的平均动脉压随着七氟醚浓度的增加而明显降低。其SEP潜伏期明显延长,波幅明显下降。两组患者间P15、N20、P25波潜伏期及P15-N20、N20-P25波幅的变化无统计学差异(P>0.05)。结论术前含服硝苯地平对吸入七氟醚麻醉中体感诱发电位监测的影响较小,可以安全地用于需监测体感诱发电位高血压患者术前降压治疗。

Objective To investigate the effects of using nifedipine preoperative during sevoflurane anesthesia on somatosensory evoked potentials(SEP)in neurosurgical patients.Methods Thirty hypertensive patients with ASAⅠ-Ⅱ,and normal SEP undergoing neurosurgery were divided into two groups randomly.Group A was treated nifedipine one hour before operation.Group B was treated a piece of amylum.After tracheal intubation,sevoflurane was inhaled and sevoflurane concentrations of intra-alveoli reached to 0.5 MAC,1.0 MAC and 1.5 MAC in turn.The mean arterial blood pressure,heart rate,and SEP were recorded in both groups.The correlation among them was calculated.Results NIBP and MAP decreased significantly after induction in both groups.With increasing concentrations of sevoflurane,MAP decreased significantly.There was a positive correlation between the latency of LP15,LN20,LP25,P15-N20 wave,N20-P25 wave and concentration of sevoflurane(P<0.05).There were no significant differences between the two groups.Conclusions There is no significant effect on SEP with using nifedipine preoperative during sevoflurane anesthesia in neurosurgical patients.