摘要
Abstract
Objective To investigate the effect of continuous infusion of cisatracurium via an infusion pump during the maintenance phase of general anesthesia on motor-evoked potentials (MEPs) in spinal cord surgery,in order to provide an evidence for rational use of muscle relaxants for MEPs monitoring during this kind of surgery.Methods Fifty patients undergoing elective spinal cord surgery with MEPs monitoring in the First Affiliated Hospital of the Medical College,Shihezi University,from March 2015 to March 2016 were enrolled and divided into control group and experimental group according to random number table with 25 in each.The 32-Channel Cascade Elite produced by Nicolet Company in America was used to monitor MEPs in both groups.The experimental group received continuous infusion of cisatracurium via an infusion pump after the induction of general anesthesia for maintaining muscle relaxation and keeping the T1 values of TOF within 45％-55％.In the control group,intravenous injection of cisatricurium 0.15 mg/kg was given at 5 s after general anesthesia induction and no longer used during the surgery.The amplitude and latency of MEPs during the surgery and emergence from anesthesia,mean arterial pressure (MAP) and heart rate at baseline (T0),immediately after tracheal intubation (T1),at 30 minutes (T2),and 120 minutes after incision(T3),the duration of surgery,intraoperative BIS value and airway pressure,emergence time,and extubation time were recorded.Results The amplitude and latency of MEPs during emergence from anesthesia did not differ significantly between the two groups (P>0.05).During the surgery,the amplitude of MEPs was significantly lower in the experimental group than that in the control group (P<0.05),but the latency of MEPs in both groups was similar (P>0.05).The control group did not demonstrate significant changes in their amplitude and latency of MEPs during the surgery and emergence from anesthesia (P>0.05).As for the experimental group,the amplitude of MEPs during the surgery was much lower than that in emergence from anesthesia (P<0.05),but the latency of MEPs measured under both conditions was similar (P>0.05).Administration method and duration of cisatracurium had no obvious interaction effects on MAP and heart rate (P>0.05),but each of them produced significant main effects on MAP and heart rate (P<0.05).Both groups had no significant differences in terms of the duration of surgery,intraoperative BIS value,airway pressure and emergence time from anesthesia (P>0.05).The experimental group was found with prolonged extubation time (P<0.05).Both groups had no intraoperative awareness.Conclusion During the maintenance phase of general anesthesia in spinal cord surgery,abandoning the use of cisatracurium has smaller effect on MEPs and might be a more favorable way for MEPs monitoring.关键词
脊髓疾病/顺式阿曲库铵/诱发电位,运动Key words
Spinal cord diseases/Cisatracurium/Evoked potentials/motor分类
医药卫生
