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.

中文翻译：

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低剂量氟哌利多降低经颅电机诱发电位的幅度：一项随机、双盲、安慰剂对照试验

背景： 

据报道，低剂量氟哌利多可抑制经颅电机诱发电位 (TCE-MEP) 的幅度，但尚未进行随机对照试验来评估这一点。这项随机、双盲、安慰剂对照试验旨在检验低剂量氟哌利多降低 TCE-MEP 幅度的假设。

方法： 

20 名年龄在 12 至 20 岁之间并计划接受矫正手术的青少年特发性脊柱侧凸女性患者被随机分配接受氟哌利多（20 µg/kg）或 0.9% 生理盐水。在记录基线 TCE-MEP 后，给予测试药物，然后每 2 分钟进行一次 TCE-MEP 记录，最长 10 分钟。主要结果是记录在左胫骨前肌中的最小相对 TCE-MEP 幅度（峰峰值幅度，基线值的百分比）。次要结果包括从研究中监测的所有其他肌肉群记录的最小相对 MEP 幅度。数据表示为中位数（四分位距）。

结果： 

与生理盐水相比，氟哌利多给药后左侧胫骨前肌的 TCE-MEP 幅度显着降低（分别为 37% [30% 至 55%] 和 76% [58% 至 93%]，P <0.01）。在其他肌肉中，除双侧拇短展肌和左侧股四头肌外，氟哌利多组的振幅降低。氟哌利多组腓肠肌记录的双侧F波相对振幅降低。

结论： 

低剂量氟哌利多 (20 µg/kg) 降低了 TCE-MEP 振幅。麻醉师应注意术中 TCE-MEP 记录期间氟哌利多的给药时间，即使使用的是低剂量。