不同麻醉方式对脊柱侧弯矫形术患者循环及神经功能的影响

摘要

目的 探究不同麻醉方式对脊柱侧弯矫形术中血流动力学和神经电生理监测(intraoperative neurophysi-ological monitoring,IONM)指标以及术后认知功能的影响.方法 选择2012年1月—2015年6月在我院接受脊柱侧弯矫形术的患者100例,以数字表法随机分为观察组和对照组,每组各50例.观察组采用丙泊酚联合七氟醚麻醉,对照组采用丙泊酚全静脉麻醉.观察对比两组麻醉诱导前15 min(T0)、插管即刻(T1)、手术30 min(T2)、手术120 min(T3)的生命体征、体感诱发电位(somatosensory evoked potential,SEP)、运动诱发电位(motor evoked potentials,MEP)、术后拔管时间以及术后认知功能的变化.结果 在T0时刻两组各项观察指标比较差异无统计学意义(P>0.05).在T1、T2、T3时刻观察组平均动脉压(MAP)低于对照组,而心率(HR)高于对照组(P0.05).结论 脊柱侧弯矫形术中应用丙泊酚联合七氟醚麻醉对SEP、MEP及血流动力学影响小,术后恢复快.%Objective To explore the effects of different anesthesia methods on hemodynamics and neurophysiological monitoring intraoperative ( IONM) and postoperative cognitive function in patients in scoliosis correction surgery. Methods 100 patients undergoing scoliosis correction surgery were randomly divided into observation group and control group ( n=50 in each group) during January 2012 and June 2015 in our hospital. The observation group used Sevoflurane combined with Propofol anesthesia, the control group used Propofol total intravenous anesthesia. The vital signs, somatosensory evoked poten-tial ( SEP) , motor evoked potential ( MEP) , extubation time and postoperative cognitive function change in two groups were compared in different time periods:15 min ( T0 ) before induction, during intubation ( T1 ) , in 30 min ( T2 ) during operation 120 min (T3) during operation. Results There was no significant difference (P> 0. 05) between the two groups at the time of T0. In T1 , T2 , T3 time periods, the observation group's mean arterial pressure ( MAP) was lower than that of the control group, while the heart rate (HR) was faster than that of the control group (P0. 05). Conclusion The application of Propofol combined with Sevoflurane anesthesia has little impact on SEP, MEP and hemodynamics, and postoperative recovery is quick in scoliosis surgery.