New spinal cord functional monitoring for aortic surgery-HFO analysis

主动脉手术的新型脊髓功能监测——HFO 分析

• 批准号: 17591479
• 负责人: OSHIRO Masakatsu
• 金额: $ 2.39万
• 依托单位: University of the Ryukyus
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2005
• 资助国家: 日本
• 起止时间: 2005 至 2007
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17591479/
• 关键词: spinal cord ischemia; SEP; MEP; HFO analysis; paraplegia; Aortic surgery; 脊髄機能モニタリング; 運動誘発電位; 脊髄運動神経細胞; プロポフォール

The aim of this project was to investigate whether High frequency analysis of Somatosensory evoked potentials (SEP) can provide excellent efficacy for detecting the spinal cord ischemia during aortic cross clamping. Using the rat's spinal cord ischemic model, transcranial motor evoked potential monitoring can detect the spinal cord ischemia within 2min after aortic cross clamp, which was much faster to detect spinal cord ischemia than that by somatosensory evoked potentials. According to high frequency analysis of SEP, high frequency of analysis of SEP did not reflect spinal cord function, but supraspinal function. Therefore, our conclusion was that high frequency analysis of SEP could not be new spinal cord functional monitoring for aortic surgery. However, in this project, we found that transcranial motor evoked potentials monitoring can provide rapid detection for spinal cord ischemia after aortic occlusion, and the P50_<MEP> and P50_<SCEP> which represent the interval of aortic occlusion associated with 50 % probability of assessment of ischemic spinal cord dysfunction by MEP and SCEP were 0.3+/- 0.1 min and 6.2+/- 0.5 min, respectively.Our data indicated that tc-MEP monitoring could detect the onset of spinal cord ischemia so rapidly in comparison with segmental SCEP monitoring, which could provide therapeutic windows in a surgical approach that includes spinal cord protection.

本研究旨在探讨高频体感诱发电位（SEP）对主动脉阻断时脊髓缺血的诊断价值。采用大鼠脊髓缺血模型，经颅运动诱发电位监测可在主动脉阻断后2 min内检测到脊髓缺血，比体感诱发电位检测脊髓缺血快得多。从SEP高频分析来看，SEP高频分析不能反映脊髓功能，而只能反映脊髓上的功能。因此，我们的结论是，SEP的高频分析不能作为新的脊髓功能监测主动脉手术。然而，在本项目中，我们发现经颅运动诱发电位监测可以提供对主动脉阻断后脊髓缺血的快速检测，并且代表与MEP和SCEP评估缺血性脊髓功能障碍的50%概率相关的主动脉阻断间期的P50_<MEP>和P50_分别为0.3+/- 0.1 min和6.2+/- 0.5 min<SCEP>，我们的数据表明，与节段性SCEP监测相比，tc-MEP监测可以如此快速地检测脊髓缺血的发作，节段性SCEP监测可以在包括脊髓保护的手术方法中提供治疗窗口。

项目成果

Nitrous oxide can enhance the hypnotic effect, but not suppression of the spinal motor neuron exccitability by propofol in human.

一氧化二氮可增强异丙酚对人的催眠作用，但不抑制脊髓运动神经元的兴奋性。

• 发表时间: 2006
• 期刊: J Anesth 20
• 作者: Kakinohana M;他;Kakinohana M
• 通讯作者: Kakinohana M

Spinal cord ischemia and opioids. 2005 ; 96-106

脊髓缺血和阿片类药物。

• 发表时间: 2005
• 作者: 垣花学;大城匡勝;Kakinohana M.
• 通讯作者: Kakinohana M.

Intravenous infusion of dexmedetomidine can prevent the degeneration of spinal ventral neurons induced by intrathecal morphine after a noninjurious interval of spinal cord ischemia in rats.

静脉输注右美托咪定可预防大鼠脊髓缺血非损伤性间隔后鞘内注射吗啡引起的脊髓腹侧神经元变性。

• 发表时间: 2007
• 期刊: Anesthesia and Analgesia 105
• 作者: Kakinohana M;Saikawa S;他
• 通讯作者: 他

Level of conseiousness affects the excitability of spinal motor neurones during propofol sedation in humans.

意识水平影响人类丙泊酚镇静期间脊髓运动神经元的兴奋性。

• 发表时间: 2006
• 期刊: Br J Anaesth 96・6
• 作者: M Kakinohana;S Nakamura;T Fuchigami;Y Miyata;K Sugahara;M Kakinohana et al.
• 通讯作者: M Kakinohana et al.

Intrathecal fentanyl can induce spastic paraplegia after transient spinalcord ischemia in the rat.

鞘内注射芬太尼可在大鼠短暂脊髓缺血后诱发痉挛性截瘫。

• 发表时间: 2005
• 作者: 垣花学;大城匡勝;Kakinohana M.;Kakinohana M;垣花学;Oshiro M
• 通讯作者: Oshiro M