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目的:观察七氟烷暴露新生儿术后早期脑干听觉诱发电位的变化。方法:行胃肠手术新生儿60例,胎龄37～42周,出生体重≥2 500 g,出生后1 min和5 min Apgar评分≥8分,ASAⅠ或Ⅱ级,按七氟烷暴露剂量,将患儿随机均分为3组(n=20):呼气末七氟烷浓度(CET-SEV)×吸入七氟烷时间(h)≤3.3%组(S1组)、3.3%0.05)。结论:吸入较大剂量七氟烷新生儿术后早期出现一过性BAEP异常。
Objective: To observe the change of brainstem auditory evoked potentials in neonates with sevoflurane exposure. Methods: Sixty newborns undergoing gastrointestinal surgery were enrolled in this study. The gestational age ranged from 37 to 42 weeks. The birth weight was ≥2 500 g, Apgar score ≥8 at 1 min and 5 min after birth, ASA Ⅰ or Ⅱ, The children were randomly divided into three groups (n = 20): end-tidal sevoflurane concentration (CET-SEV) × inhalation sevoflurane time (h) ≤3.3% (group S1), 3.3% SEV × sevoflurane inhalation time (h) <6.6% (group S2), CET-SEV × inhalation sevoflurane time (h) group ≥6.6% (group S3), during the same period, 20 newborns served as control group (C group, n = 20). The experimental group was induced by inhalation of 4% sevoflurane, sevoflurane was maintained during operation, and end-tidal sevoflurane concentration was monitored by gas monitor. The brainstem auditory evoked potentials (BAEP) were measured in the experimental group at 48 h and 7 d after operation, respectively. The control group received BAEP at the same period. Results: The abnormal BAEP rate of sevoflurane exposure group was 45% at 48 h after operation, which was mainly manifested as poor or disappearance of Ⅴ wave, prolonged Ⅴ wave latency (PL), prolonged I-V wave interval (IPL), and In group C, the difference of BAEP between S2 group and S3 group and the IPL of I-V wave in S3 group were statistically significant (P <0.05). At 7 days after operation, BAEP in sevoflurane group was mainly prolonged Ⅴ wave PL and I- Ⅴ wave IPL prolonged, compared with the C group, BAEP abnormal rate, PL and IPL were no significant difference (P> 0.05). Conclusions: A transient BAEP abnormality occurs in the early stage after inhalation of larger doses of sevoflurane.