CAJ | 학술논문

目的：探讨赛机宁不同外周神经肌肉阻滞程度( NMB)对脑瘫患儿脊神经根诱发肌电图监测的影响。方法择期拟行功能性选择性腰部脊神经后根切断术的脑瘫患儿20例,ASA Ⅰ或Ⅱ级,年龄3~12岁,性别不限。麻醉诱导后,使用Nicolet Endeavor-CR16通道的电生理监护仪,对拟切除的脊神经后根连续3次电刺激,间隔时间为5s,刺激强度为3．50mA,记录所刺激的神经根诱发相应肌群肌电图( EEMG)的平均振幅和潜伏期作为基础值。静脉推注赛机宁0．05 mg/kg,当外周神经肌肉阻滞程度分别为100%、75%、50%、25%时再次以同样的强度刺激及间隔时间连续进行3次电刺激,记录EEMG的平均振幅和潜伏期。观察振幅保留比率和潜伏期的变化与赛机宁不同NMB程度之间的关系。结果随着NMB减少,振幅保留比率逐渐增大,振幅保留比率(Y)与NMB(X)呈负相关关系,相关系数R为0．960a(P<0．01)。NMB在50%~100%时,潜伏期较基础值明显延长,潜伏期(Y)与NMB(X)呈正相关关系,相关系数R为0．481a(P<0．01)。结论赛机宁可影响脊神经根诱发肌电图监测,随着NMB程度逐渐降低,振幅保留比率逐渐增大,潜伏期缩短。
목적：탐토새궤저불동외주신경기육조체정도( NMB)대뇌탄환인척신경근유발기전도감측적영향。방법택기의행공능성선택성요부척신경후근절단술적뇌탄환인20례,ASA Ⅰ혹Ⅱ급,년령3~12세,성별불한。마취유도후,사용Nicolet Endeavor-CR16통도적전생리감호의,대의절제적척신경후근련속3차전자격,간격시간위5s,자격강도위3．50mA,기록소자격적신경근유발상응기군기전도( EEMG)적평균진폭화잠복기작위기출치。정맥추주새궤저0．05 mg/kg,당외주신경기육조체정도분별위100%、75%、50%、25%시재차이동양적강도자격급간격시간련속진행3차전자격,기록EEMG적평균진폭화잠복기。관찰진폭보류비솔화잠복기적변화여새궤저불동NMB정도지간적관계。결과수착NMB감소,진폭보류비솔축점증대,진폭보류비솔(Y)여NMB(X)정부상관관계,상관계수R위0．960a(P<0．01)。NMB재50%~100%시,잠복기교기출치명현연장,잠복기(Y)여NMB(X)정정상관관계,상관계수R위0．481a(P<0．01)。결론새궤저가영향척신경근유발기전도감측,수착NMB정도축점강저,진폭보류비솔축점증대,잠복기축단。
Objective To investigate the effect of nimbex different peripheral neuromuscular blockade( NMB) on evoked electromyography monitoring( EEMG) of spinal nerve root in children with cerebral palsy. Methods Twenty ASA physical statusⅠorⅡchildren with cerebral palsy of both sexes, aged 3-12 yr, scheduled for elective functional selectivity of lumbar posterior rhi-zotomy, were included in the study. After induction of anesthesia, the spinal nerve root was accepted continuous electrical stimula-tion for 3 times with the electrophysiological monitoring of Nicolet Endeavor-CR 16 channel, interval 5s, the stimulus intensity of 3. 50 mA. The average amplitude and latency ofEEMGwere recorded as basic values. Intravenously injection nimbex 0. 05mg/kg,then the spinal nerve root was accepted continuous electrical stimulation for 3 times as the same intensity of stimulation and the inter-val time when NMB were 100%, 75%, 50%, 25%. The average amplitude and latency were recorded respectively,then analyzed the relationship betweenamplitude retention ratio andlatency with nimbex different NMB. Results With the decrease of NMB, the amplitude retention ratio was increases, the amplitude retention ratio ( Y) and NMB ( X) showed negative correlation, the correlation coefficient R was 0. 960 a(P<0. 01). When NMB was 50% ~ 100%, the latency was significantly prolonged than basic values, the latency( Y) and NMB( X) is positive correlation, the correlation coefficient R was 0. 481 a ( P< 0. 01 ) . Conclusion The nimbex would affect the spinal nerve root EEMG. With the degree of NMB gradually decreased, the amplitude retention ratio was increases and the latency was shortening gradually.