Use of dexmedetomidine and ketamine infusions during scoliosis repair surgery with somatosensory and motor-evoked potential monitoring: a case report.
Use of dexmedetomidine and ketamine infusions during scoliosis repair surgery with somatosensory and motor-evoked potential monitoring: a case report.
复制标题
在脊柱侧凸修复手术中使用右美托咪定和氯胺酮输注并进行体感和运动诱发电位监测：病例报告。
作者：
R. Penney
右美托咪定和氯胺酮输注是一名15岁女孩的主要麻醉剂，该女孩接受了脊柱侧凸修复手术，并进行了术中唤醒试验、体感诱发电位（SSEP）和运动诱发电位（MEP）监测。为维持麻醉，同时给予右美托咪定和氯胺酮。在整个病例中，右美托咪定剂量范围为0.9 - 1.2 μ g/kg/h，氯胺酮剂量范围为0.4 - 0.6 mg/kg/h。右美托咪定和氯胺酮的镇痛特性通过以每小时1至2微克/千克的持续芬太尼输注来补充。右美托咪定的交感神经阻滞特性与氯胺酮的拟交感神经特性平衡，患者需要最低限度的血管活性支持（在12小时的麻醉护理过程中仅给予250 μ g苯丙氨酸）。该麻醉方案以及60%笑气和40%氧气为术中神经生理监测提供了满意的条件。本病例报告讨论了在脊柱侧凸修复手术中使用右美托咪定和氯胺酮输注作为丙泊酚全静脉麻醉的替代方法，术中进行SSEP和MEP监测。
Dexmedetomidine and ketamine infusions were the main anesthetic for a 15-year-old girl, who underwent scoliosis repair surgery with intraoperative wake-up test, somatosensory evoked potential (SSEP), and motor-evoked potential (MEP) monitoring. To achieve maintenance of anesthesia, dexmedetomidine and ketamine were administered concomitantly. The dexmedetomidine dose ranged from 0.9 to 1.2 microg/kg per hour throughout the case, and the ketamine dose ranged from 0.4 to 0.6 mg/kg per hour. The analgesic properties of dexmedetomidine and ketamine were complimented by the continuous fentanyl infusion at 1 to 2 microg/kg per hour. The sympatholytic properties of dexmedetomidine were balanced with the sympathomimetic properties of ketamine, and the patient required minimal vasoactive support (only 250 microg of phenylephrine was administered over the course of 12 hours of anesthetic care). This anesthetic regimen, as well as 60% nitrous oxide and 40% oxygen, provided satisfactory conditions for the intraoperative neurophysiologic monitoring. This case report discusses the use of dexmedetomidine and ketamine infusions as an alternative to propofol-based total intravenous anesthesia during scoliosis repair surgery with intraoperative SSEP and MEP monitoring.
DOI：
10.1124/jpet.300.1.282
发表时间：
2002-01-01
影响因子：
3.5
作者：
Fairbanks, CA;Stone, LS;Wilcox, GL
通讯作者：
Wilcox, GL