高輝度光刺激装置を用いた視覚誘発電位モニタリングの信頼性の検討  [in Japanese] Reliability of Intraoperative Visual Evoked Potential Monitoring during Neurosurgery  [in Japanese]

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Abstract

術後視機能障害を回避するために視覚誘発電位(VEP)モニタリングが使用される.高輝度光刺激装置の使用,網膜への光刺激到達を確認するための網膜電図の併用により再現性のあるVEP記録が可能になった.今回,われわれは視機能障害リスクのある脳神経外科手術で行われたVEPモニタリングの信頼性について検討した.118症例中113症例でコントロールVEPの記録が可能であった.20例で有意なVEP振幅低下を認め,そのうち16例は一時的振幅低下,4例は手術終了時までの継続的振幅低下であった.全例で術後視機能障害を認めなかったので視機能障害を検知するためのVEP変化の感度は算出できなかったが,特異度は96.5%であった.

Visual evoked potential (VEP) is used to monitor the integrity of the optic pathway. In this study, we evaluated the reliability of intraoperative VEP monitoring to detect visual dysfunction during neurosurgery that poses a risk of postoperative visual dysfunction (POVD). Anesthesia was maintained by total intravenous anesthesia using propofol. Significant change in VEP was defined as a more than 50% decrease compared to control VEP. Control VEP was recorded successfully in 113 of 118 cases. Significant VEP changes were observed in 20 cases during the operation. Of the 20 cases with intraoperative significant VEP change, 16 cases had temporary change and 4 cases had continuous change until the end of the operation. There was no case with POVD. The specificity of intraoperative VEP monitoring was 96.5%. The sensitivity was not calculated. The results of this study showed the feasibility of VEP monitoring during neurosurgery that poses a risk of POVD.

Journal

  • THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA

    THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 36(2), 141-146, 2016

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA

Codes

  • NII Article ID (NAID)
    130005147279
  • Text Lang
    JPN
  • ISSN
    0285-4945
  • Data Source
    J-STAGE 
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