Influence of different anesthesia methods on neurophysiological monitoring indicators SEP and MEP during scoliosis correction surgery
脊柱侧弯矫形术中不同麻醉方法对神经电生理监测指标SEP及MEP的影响分析

摘要

目的 探讨全凭静脉麻醉联合右美托咪定、全凭静脉麻醉联合低MAC七氟醚、全凭静脉麻醉三种方案对脊柱侧弯矫形术中体感诱发电位（SEP）及运动诱发电位（MEP）的影响。方法 选取2024年3月—2025年3月拟行脊柱侧弯矫形术患者249例，随机分为A组（83例，全凭静脉麻醉联合右美托咪定）、B组（83例，全凭静脉麻醉联合低MAC七氟醚）、C组（83例，全凭静脉麻醉），监测术前、术中、术后SEP潜伏期、MEP波幅及指标异常发生率。结果 A组术中上肢N20潜伏期（18.25±1.36）ms、下肢P40潜伏期（42.18±2.57）ms，显著短于B组、C组（P<0.05）；A组MEP平均波幅（286.45±32.18）μV，高于B组、C组（P<0.05）；A组异常发生率3.61%，低于B组13.25%、C组10.84%（P<0.05）。结论 全身麻醉联合右美托咪定可稳定脊柱侧弯矫形术中SEP及MEP指标，降低异常发生率，更利于神经功能监测。

Abstract

Objective To investigate the effects of three anesthesia regimens—total intravenous anesthesia combined with dexmedetomidine, total intravenous anesthesia combined with low-MAC sevoflurane, and total intravenous anesthesia—on somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) during scoliosis correction surgery.
Methods A total of 249 patients scheduled for scoliosis correction surgery from March 2024 to March 2025 were randomly divided into group A (n=83, total intravenous anesthesia combined with dexmedetomidine), group B (n=83, total intravenous anesthesia combined with low-MAC sevoflurane), and group C (n=83, total intravenous anesthesia). SEP latency, MEP amplitude, and the incidence of abnormal indicators were monitored preoperatively, intraoperatively, and postoperatively.
Results The intraoperative N20 latency in the upper limbs (18.25±1.36 ms) and P40 latency in the lower limbs (42.18±2.57 ms) in group A were significantly shorter than those in groups B and C (P<0.05). The mean amplitude of MEP in group A (286.45±32.18 μV) was higher than that in groups B and C (P<0.05). The abnormality rate in group A was 3.61%, lower than that in group B (13.25%) and group C (10.84%) (P<0.05).
Conclusion   General anesthesia combined with dexmedetomidine can stabilize SEP and MEP indices during scoliosis correction surgery, reduce the abnormality rate, and facilitate neurological function monitoring.