Neurological Surgery 脳神経外科51巻3号

2023年05月発行

特集 Theモニタリング—基本から応用まで Ⅲ モニタリング対象別

眼球運動モニタリング

著者： 西村文彦¹ 中瀬裕之¹

所属機関： ¹奈良県立医科大学脳神経外科

ページ範囲：P.460 - P.469

Point
・頭蓋底腫瘍摘出時，特に海綿静脈洞部へ手術操作が及ぶ場合には眼球運動モニタリングが必須となる．
・麻酔は吸入麻酔，全静脈麻酔いずれも可能であるが，筋電図を記録するために筋弛緩薬は麻酔導入時のみ使用し，術中の追加は最小限にとどめる．術中運動誘発電位，視覚誘発電位などシナプスを介するモニタリング併用時は，静脈麻酔下に行う．
・脳神経を直接刺激する場合は0.2〜2.0 mA，腫瘍表面や腫瘍内から間接的に刺激する場合は2.0〜4.0 mA程度の刺激強度で行う．
・術中ナビゲーションを併用する場合，光学式であれば問題ないが，磁場式の場合は波形にアーチファクトが入りやすく，モニタリングに重点を置くときは，いったんナビゲーションをオフにする工夫が必要である．
＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2026年6月まで）。

参考文献

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