| 杜治昆.不同剂量阿曲库铵对脑肿瘤切除术患者MEP及SEP变化及不良反应的影响#$NL杜治昆#$NL南阳市中心医院 急诊创伤外科 河南南阳 473000[J].实用中西医结合临床,2021,21(5): |
| 不同剂量阿曲库铵对脑肿瘤切除术患者MEP及SEP变化及不良反应的影响#$NL杜治昆#$NL南阳市中心医院 急诊创伤外科 河南南阳 473000 |
| Effects of Different Doses of Tracurium on MEP and SEP Changes and Adverse Reactions in Patients with Brain Tumor Resection |
| 投稿时间：2020-11-12 修订日期：2020-11-12 |
| DOI： |
| 中文关键词: 阿曲库铵 脑肿瘤切除术 MEP SEP 不良反应 |
| 英文关键词: Atracurium Brain tumor resection MEP SEP Adverse reactions |
| 基金项目: |
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| 中文摘要: |
| 目的 S研究不同剂量阿曲库铵对脑肿瘤切除术患者运动诱发电位(MEP)及体感诱发电位(SEP)变化及不良反应的影响。方法：选择2016年6月-2019年6月经我院收治的已行脑肿瘤切除术患者125例,根据使用阿曲库铵剂量不同分为小剂量组(n=40)、中剂量组(n=43)和大剂量组(n=42)。比较三组生命体征的变化、麻醉用量、MEP与SEP变化、不良反应发生率。结果：三组患者T0时比较HR、MAP、BIS、SpO 2、RR无显著差异(P＞0.05)；小剂量组T1-T3时刻BIS、RR值较本组T0时刻显著降低(P＜0.05)；但HR、MAP无显著差异(P＞0.05)。中剂量组T1-T3时刻MAP、HR较本组T0时刻显著升高,且均显著大于小剂量组；T1-T3时刻BIS、RR较本组T0时刻显著降低,且T2时刻BIS、RR显著大于小剂量组(P＜0.05)。大剂量组T1-T3时刻MAP、HR较本组T0时刻显著升高,且均显著大于小剂量组,但小于中剂量组；T1-T3时刻BIS、RR较本组T0时刻显著降低,且T2时刻BIS、RR显著小于小、中剂量组(P＜0.05)。三组患者各时刻SPO2均无显著差异(P＞0.05)。大剂量组患者使用丙泊酚剂量、血清血药浓度均高于中、小剂量组患者(P＜0.05)；大剂量组患者引起MEP留滞时间、MEP电流强度、N20 T3时潜伏期均高于中、小剂量组患者,且N20-P25 T3时波幅低于中剂量组,但高于小剂量组(P＜0.05)；小剂量组发生不良反应率显著低于中、大剂量组患者(P＜0.05)。结论：小剂量阿曲库铵可减少对脑肿瘤切除术患者MEP、SEP影响与丙泊酚使用剂量,从而减轻患者术中不良反应发生率。 |
| 英文摘要: |
| Objective To investigate the effects of different doses of tracurium on somatosensory- and motor-evoked potential (SEP/MEP) changes and adverse reactions in patients with brain tumor resection. Methods 125 patients undergone brain tumor resection in our hospital from June 2016 to June 2019 were selected and divided into low-dose group (n = 40) and medium-dose group (n = 43) and high-dose group (n = 42) according to different doses of atracurium. Changes in vital signs, anesthesia dosage, changes in MEP and SEP, and incidence of adverse reactions were compared between the three groups. Results There was no significant difference in HR, MAP, BIS, SpO 2 and RR between the three groups at T0 (P>0.05); Compared with indexes at T0, the BIS and RR values at T1-T3 in the low-dose group were significantly decreased (P<0.05), but no significant change was observed in HR and MAP (P>0.05). Compared with indexes at T0, MAP and HR at T1-T3 were increased in medium-dose group, and were higher than those in the low-dose group (P<0.05), meanwhile, the BIS and RR were decreased in medium-dose group at T1-T3 (P<0.05), and were significantly higher than those in low-dose group at T2 (P<0.05). Compared with indexes at T0, MAP and HR in the high-dose group were increased at T1-T3, and were significantly higher than those in the low-dose group but lower than those in the medium-dose group, meanwhile, the BIS and RR were decreased in high-dose group at T1-T3, and were significantly lower than those in the low-dose group and medium-dose group (P<0.05). SPO2 had no difference among three groups at each time point (P>0.05). The dose and serum concentration of propofol in the high-dose group were higher than those in the medium-dose group and low-dose group (P<0.05). MEP retention time, MEP current intensity and latency of N20 at T3 in the high-dose group were all higher than those in the low-dose group and medium-dose group, meanwhile, the amplitude of N20-P25 at T3 was lower than that of the middle-dose group, but higher than that of the low-dose group (P<0.05). The incidence of adverse reactions in small dose group was significantly lower than that in medium and large dose group (P<0.05). Conclusion Low-dose altracurium can reduce the effects on MEP, SEP and propofol dosage on patients with brain tumor resection, and reduce the incidence of adverse reactions during surgery. |
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