Intraoperative monitoring of evoked potentials of thoracic sympathetic trunk

术中胸交感干诱发电位监测

• 批准号: 12671473
• 负责人: KAWAI Kouji
• 金额: $ 2.37万
• 依托单位: Yamaguchi University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12671473/
• 关键词: endoscopic thoracic sympathetectomy; hyperhidrosis; evoked potential; sympathetic block; thoracicsympathetic trunk; surgical procedure; electrical stimulation; CRPS; 原発性手掌多汗症; 胸部交感神経幹; 交感神経機能; 交感神経皮膚反応; 代償性発汗; Skin Vasomotor Reflex

In recent years, the efficacy of endoscopic thoracic sympathectomy for palmar hyperhidrosis has been more closely evaluated. We have adopted the evoked potential of thoracic sympathetic trunk to determine the area of amptation and to evaluate the intensity of sympathetic blockade as an intraoperative monitoring. The evoked potential was observed in 13 cases of 16 cases. (Of the 16 patients studied, 2 were CRPS and 14 were hyperhidrosis. Their ages varied from 14 to 65 years.) The potentials evoked by the electrical stimulation (Intensity:1-5mA, Interval:13msec, Duration:0.1ms, Train:170 times.) were tried to be recorded on palm, axilla, chest, and sole. Multi-phasic waves were recorded only on palm by stimulating the sympathetic trunk on 2nd and 3rd rib. These were not recorded on axilla, chest, and sole. After sympathectomy, though the evoked potentials by stimulating the sympathetic trunk on 2nd rib were observed, those on 3rd rib were disappeared. The evoked potential by stimulating the sympathetic trunk between Th2 and Th3 was disappeared after sympathectomy in all cases. The study provides additional information as to the proper procedure of the endoscopic thoracic sympathectomy.

近年来，内窥镜胸交感神经切除术治疗手汗症的疗效得到了更密切的评价。我们采用胸交感神经干诱发电位作为术中监测，以确定麻醉范围和评价交感神经阻滞的强度。16例中13例进行了诱发电位观察。(Of 16例患者中，2例为CRPS，14例为多汗症。他们的年龄从14岁到65岁不等）。电刺激（强度：1- 5 mA，间隔：13 msec，持续时间：0.1ms，Train：170次）诱发的电位。试图在手掌、腋窝、胸部和脚掌上记录。刺激第2、3肋交感干，在手掌记录多相波。腋窝、胸部和脚底没有记录这些情况。交感神经切断后，刺激第2肋交感神经干虽可观察到诱发电位，但第3肋交感神经干的诱发电位消失。交感神经切断后，刺激Th 2 ~ Th 3之间的交感神经干诱发电位均消失。该研究提供了额外的信息，以适当的程序内镜胸交感神经切除术。