关键词: 神经电生理监测, 运动诱发电位, 肌松药, 体感诱发电位, 全静脉麻醉

Abstract: ［Abstract］ Objective To compare the effects of total intravenous anesthesia with or without muscle relaxants on combined electroneurophilogy monitoring of the spinal cord during the spinal surgery， and to explore a safe and effective anesthesia protocol for electroneurophilogy monitoring. Methods Forty patients undergoing selective spinal surgery who underwent combined electroneurophilogy monitoring were enrolled and divided into A and B groups. All patients were anesthetized by propofol， remifentanil and dexmedetomidine. Patients in group A were treated with small doses of atracurium to maintain muscle relaxation during the surgery， while patients in group B were treated without muscle relaxants. Combined electroneurophilogy monitoring， somatosensory evoked potentials （SEP） and motor evoked potentials （MEP）， were used to monitor the spinal cord function. The amplitudes and latencies of SEP and MEP were recorded at different time points during the operation， and the occurrence of severe body motility and spontaneous breathing during transcranial electrical stimulation was also recorded. The recovery time and quality of anesthesia after operation were compared between the two groups. Results There was no significant difference in the amplitude and latency of SEP between the two groups at different time points. The latencies of MEP were similar （P>0.05）， while the amplitudes of MEP had significant difference between two groups （P<0.05）. No spontaneous breathing and severe body motility was detected during the surgery. The recovery time in group B is significantly shorter than that in group A （P<0.01）. Conclusion Our protocol of total intravenous anesthesia （propofol， remifentanil and dexmedetomidine） without muscle relaxants can be safely and effectively applied in spinal surgery with combined electroneurophilogy monitoring， and has obvious advantages in signal quality and postoperative recovery.

Key words: muscle relaxants, somatosensory evoked potentials, total intravenous anesthesia, electroneurophilogy monitoring, motor evoked potentials