[Effects of sevoflurane and propofol on evoked potentials during neurosurgical anesthesia].
[Effects of sevoflurane and propofol on evoked potentials during neurosurgical anesthesia].
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七氟醚和丙泊酚对神经外科麻醉诱发电位的影响
DOI：
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
Takahiro Kato
中科院分区：
文献类型：
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作者：
I. Nakagawa;S. Hidaka;H. Okada;T. Kubo;K. Okamura;Takahiro Kato
背景
麻醉药对体感诱发电位（SEP）和听性脑干反应（ABR）的影响是近二十年来研究的热点。事实上，挥发性麻醉剂已多次被证明以剂量依赖性方式降低皮层振幅，但关于丙泊酚作用的信息是不完整的。本研究的目的是比较七氟醚和丙泊酚在脑电双频指数（BIS）指导下的麻醉深度相当时对诱发电位的影响。
方法
研究了44例神经外科手术患者。采用靶控输注（TCI）丙泊酚维持麻醉。分别测定了七氟醚（0%、1%、2%）和异丙酚（效应室浓度分别为1.5、2.0、3.0 μ g × ml~（-1））三种浓度时SEP（N20-P25）、ABR（V波）和VEP（P100）的波幅和潜伏期的变化。采用BIS监测仪测定相对催眠深度。
结果
随着七氟醚浓度的增加（0、1%和2%），SEP的振幅呈剂量相关性降低，ABR的变化不明显，VEP在1%时显著降低。与1.5 μ g x ml（-1）浓度下的振幅相比，异丙酚浓度为3.0 μ g x ml（-1）时的VEP显着降低。SEP和ABR随丙泊酚剂量的变化无明显变化。两种麻醉药的BIS值几乎相同。
结论
麻醉剂对VEP的影响最大，七氟烷和丙泊酚对ABR的影响较小。异丙酚为基础的TIVA技术引起的诱发电位变化小于七氟烷。
BACKGROUND
The effect of anesthetics on somatosensory evoked potential (SEP) and auditory brain stem response (ABR) has been a subject of intense reseach over the last two decades. In fact, volatile anesthetics have been repeatedly shown to decrease cortical amplitude in a dose-dependent fashion but the information regarding the effect of propofol is incomplete. The purpose of this study was to compare the effects of sevoflurane and propofol on evoked potentials during comparable depth of anesthesia guided by bispectral index (BIS).
METHODS
Forty four patients scheduled for neurosurgery were studied. Anesthesia was maintained with intravenous propofol using target controlled infusion (TCI). We measured the change of amplitude and latency of SEP(N20-P25), ABR (V wave) and visual evoked potential (VEP: P100) at three sets of sevoflurane (0%, 1%, 2%) or propofol concentrations (effect site concentration of 1.5, 2.0, 3.0 microug x ml(-1)). BIS monitor was used to measure relative depth of hypnosis.
RESULTS
With increasing concentrations of sevoflurane (0, 1% and 2%), SEP showed dose-related reduction in its amplitude, ABR produced less marked changes and VEP showed a significant reduction at 1%. VEP at the propofol concentration of 3.0 microg x ml(-1) was decreased significantly compared with the amplitude at 1.5 microg x ml(-1) concentration. No significant change was observed with SEP and ABR during the change of propofol dosages. BIS values were almost the same with each anesthetics.
CONCLUSIONS
VEP was most strongly affected with anesthetics, and ABR showed less marked influence of sevoflurane and propofol. Propofol based TIVA technique would induce less change in evoked potentials than sevoflurane.