[Intraoperative monitoring of visual evoked potentials].
[Intraoperative monitoring of visual evoked potentials].
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术中视觉诱发电位监测[J].
DOI：
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
M. Murakawa
中科院分区：
文献类型：
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作者：
Tatsuya Sasaki;Tsuyoshi Ichikawa;J. Sakuma;Kyouichi Suzuki;M. Matsumoto;Takeshi Itakura;N. Kodama;M. Murakawa
过去我们术中视觉诱发电位（VEP）监测的成功率约为30%。为了提高术中VEP的记录率，我们研制了一种新型的大功率发光二极管刺激装置。同时记录视网膜电图以了解闪光刺激是否到达视网膜。此外，采用丙泊酚全静脉麻醉，避免了吸入麻醉的不良反应。我们报告的结果后，介绍这些改进。35例术中进行了VEP监测。我们评估VEP记录的成功率，VEP结果与术后视功能的相关性，以及记录失败的原因。59侧（84%）获得稳定和可重复的波形。术中VEP恶化2例，术后视力障碍：11侧（16%）未获得稳定波形。有两个主要原因。在11侧中的8侧中，原因归因于预先存在的严重视觉障碍。在这8侧中，清醒状态下的VEP不可记录或可记录，但幅度非常低，低于1 microV。另外3侧的原因是刺激装置反射额颞部头皮瓣移动。总之，在引入各种试验后，成功记录率从约30%提高到84%。术中VEP的记录有待进一步完善，以建立一种可靠的术中VEP监测方法。
Our success rate of intraoperative monitoring of visual evoked potential (VEP) had been approximately 30% in the past. In order to improve recording rate of intraoperative VEP, we developed a new stimulating device using high power light emitting diodes. Electroretinogram was simultaneously recorded to understand whether flash stimulation reached the retina. In addition, total venous anesthesia with propofol was used to avoid the adverse effect of inhalation anesthesia. We report the results after introduction of these improvements. Intraoperative monitoring of VEP was attempted in 35 cases. We evaluated success rate of VEP recording, correlation between VEP findings and postoperative visual function, and reasons why recording was not successful. Stable and reproducible waveforms were obtained in 59 sides (84%). Two cases, whose VEP deteriorated intraoperatively, developed postoperative visual disturbance: In 11 sides (16%), stable waveforms were not obtained. There were two main causes. In 8 sides out of 11, the cause was attributed to pre-existing severe visual disturbance. In these 8 sides, VEP in the awake state was not recordable or was recordable, but with very low amplitudes under 1 microV. In the other 3 sides, the cause was attributed to movement of a stimulating device by reflecting the fronto-temporal scalp flap. In conclusion, the successful recording rate was increased to 84% from approximately 30%, after introduction of various trials. We need further improvement in recording intraoperative VEP to establish a reliable intraoperative monitoring method for VEP.