Low-dose Droperidol Reduces the Amplitude of Transcranial Electrical Motor-evoked Potential
Low-dose Droperidol Reduces the Amplitude of Transcranial Electrical Motor-evoked Potential
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低剂量氟哌利多降低经颅电动诱发电位的幅度
DOI：
10.1097/ana.0000000000000784
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发表时间：
2021
影响因子：
3.7
通讯作者：
Baba Hiroshi
中科院分区：
文献类型：
--
作者：
Mitsuma Yusuke;Furutani Kenta;Deguchi Hiroyuki;Kamiya Yoshinori;Tanaka Takahiro;Kitamura Nobutaka;Baba Hiroshi
背景：据报道，小剂量氟哌利多可抑制经颅电运动诱发电位(TCE-MEP)的波幅，但尚未进行随机对照试验进行评估。这项随机、双盲、安慰剂对照试验旨在验证小剂量氟哌利多降低TCE-MEP波幅的假说。方法：20例青少年特发性脊柱侧凸患者，年龄在12岁至20岁之间，计划接受矫正手术，随机分为氟哌利多(20µg/kg)或0.9%生理盐水。在记录基线TCE-MEP后，给药，然后每2分钟进行一次TCE-MEP记录，最长持续10分钟。主要结果是左侧胫前肌记录的最小相对TCE-MEP幅度(峰峰值幅度，基线值百分比)。次要结果包括从研究中监测的所有其他肌肉组记录的最小相对MEP幅度。结果：给予氟哌利多后，左侧胫前肌的TCE-MEP波幅较生理盐水显著降低(分别为37%[30%~55%]和76%[58%~93%]，P<；0.01)。在其他肌肉中，氟哌利多组除双侧拇短展肌和左股四头肌外，其余肌肉波幅均降低。结论：小剂量氟哌利多(20µg/kg)可降低TCE-MEP波幅。麻醉医师在术中TCE-MEP记录时应注意氟哌利多的给药时机，即使是小剂量使用。
Background:Low-dose droperidol has been reported to suppress the amplitude of transcranial electrical motor-evoked potentials (TCE-MEPs), but no randomized controlled trials have been conducted to assess this. This randomized, double-blinded, placebo-controlled trial aimed to test the hypothesis that low-dose droperidol reduced TCE-MEP amplitudes.Methods:Twenty female patients with adolescent idiopathic scoliosis, aged between 12 and 20 years, and scheduled to undergo corrective surgery were randomly allocated to receive droperidol (20 µg/kg) or 0.9% saline. After recording baseline TCE-MEPs, the test drug was administered, following which TCE-MEP recordings were carried out every 2 minutes for up to 10 minutes. The primary outcome was the minimum relative TCE-MEP amplitude (peak-to-peak amplitude, percentage of baseline value) recorded in the left tibialis anterior muscle. Secondary outcomes included minimum relative MEP amplitudes recorded from all other muscle groups monitored in the study. Data are expressed as medians (interquartile range).Results:The TCE-MEP amplitude of the left tibialis anterior muscle was significantly reduced following droperidol administration compared with saline (37%[30% to 55%] vs. 76%[58% to 93%], respectively, P< 0.01). In the other muscles, the amplitudes were reduced in the droperidol group, except for the bilateral abductor pollicis brevis and the left quadriceps femoris muscles. The relative amplitude of the bilateral F waves recorded from the gastrocnemius was decreased in the droperidol group.Conclusions:Low-dose droperidol (20 µg/kg) reduced TCE-MEP amplitudes. Anesthesiologists should pay attention to the timing of droperidol administration during intraoperative TCE-MEP recordings, even if used in a low dose.