【罂粟摘要】低剂量氟哌啶醇降低经颅电刺激运动诱发电位的幅度：一项随机、双盲、安慰剂对照试验

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低剂量氟哌啶醇降低经颅电刺激运动诱发电位的幅度：一项随机、双盲、安慰剂对照试验

贵州医科大学 麻醉与心脏电生理课题组

翻译：潘志军

编辑：宋雨婷

审校：曹莹

1目的

低剂量氟哌啶醇被报道可以抑制经颅电刺激运动诱发电位（TCE-MEPs）的幅度，但尚无随机对照试验来评估这一效果。本项随机、双盲、安慰剂对照试验旨在探究低剂量氟哌啶醇能否降低TCE-MEP幅度。

2方法

将20名年龄在12至20岁之间，患有特发性脊柱侧凸且计划接受矫正手术的女性患者，随机分配接受氟哌啶醇（20 µg/kg）或0.9%生理盐水。记录基线TCE-MEP后，给予试验药物，然后每2分钟进行一次TCE-MEP记录，持续10分钟。主要结局指标是左侧胫骨前肌记录的最小相对TCE-MEP幅度（峰-峰幅度，基线值的百分比）。次要结局指标包括从其他所有监测肌群记录的最小相对MEP幅度。数据以中位数（四分位数间距）表示。

3结果

与生理盐水相比，氟哌啶醇给药后左侧胫骨前肌的TCE-MEP幅度显著降低（分别为37% [30%-55%]比76% [58%-93%]，P <0.01）。除了双侧拇指展肌和左侧股四头肌，在其他肌肉中，氟哌啶醇组的幅度也降低了。从腓肠肌记录的双侧F波的相对幅度在氟哌啶醇组中也降低了。

4结论

低剂量氟哌啶醇（20 µg/kg）降低了TCE-MEP幅度。即使在使用低剂量氟哌啶醇的情况下，麻醉医师应注意氟哌啶醇在术中TCE-MEP记录期间的给药时机。

原始文献来源：

Yusuke Mitsuma,Kenta Furutani, Hiroyuki Deguchi,et al.Low-dose Droperidol Reduces the Amplitude of Transcranial Electrical Motor-evoked Potential: A Randomized, Double-blind, Placebo-controlled Trial[J]. (2022 Oct1;34(4):424-428)

英文原文

Low-dose Droperidol Reduces the Amplitude of Transcranial Electrical Motor-evoked Potential: A Randomized, Double-blind, Placebo-controlled Trial   

Background: Low-dose droperidol has been reported to suppress the amplitude of transcranial electrical motor-evoked potentials (TCE-MEPs), but no randomized controlled trials have been conducted to assess this. This randomized, double-blinded, placebo-controlled trial aimed to test the hypothesis that low-dose droperidol reduced TCE-MEP amplitudes.

Methods: Twenty female patients with adolescent idiopathic scoliosis, aged between 12 and 20 years, and scheduled to undergo corrective surgery were randomly allocated to receive droperidol (20 µg/kg) or 0.9% saline. After recording baseline TCE-MEPs, the test drug was administered, following which TCE-MEP recordings were carried out every 2 minutes for up to 10 minutes. The primary outcome was the minimum relative TCE-MEP amplitude (peak-to-peak amplitude, percentage of baseline value) recorded in the left tibialis anterior muscle. Secondary outcomes included minimum relative MEP amplitudes recorded from all other muscle groups monitored in the study. Data are expressed as medians (interquartile range).

Results: The TCE-MEP amplitude of the left tibialis anterior muscle was significantly reduced following droperidol administration compared with saline (37% [30% to 55%] vs. 76% [58% to 93%], respectively, P<0.01). In the other muscles, the amplitudes were reduced in the droperidol group, except for the bilateral abductor pollicis brevis and the left quadriceps femoris muscles. The relative amplitude of the bilateral F waves recorded from the gastrocnemius was decreased in the droperidol group.

Conclusions: Low-dose droperidol (20 µg/kg) reduced TCE-MEP amplitudes. Anesthesiologists should pay attention to the timing of droperidol administration during intraoperative TCE-MEP recordings, even if used in a low dose.

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