地氟烷和七氟烷对癫痫患者脑电图的影响  

Affect of desflurane and sevoflurane on electroencephalogram of epileptic patients

作　　者：吉勇[1] 王德祥[1] 王保国[1] 白勤[1] 张彤[1] 

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,100050

出　　处：《北京医学》2006年第2期90-93,共4页Beijing Medical Journal

摘　　要：目的对比观察不同呼气末地氟烷和七氟烷浓度时癫痫患者脑电图及棘波的变化。方法40例癫痫需行手术者,随机分为地氟烷组和七氟烷组,每组20例。以1.0最低肺泡有效浓度(MAC)的地氟烷或七氟烷维持麻醉,术中置入硬膜外电极后,调整蒸发器刻度,分别控制呼气末地氟烷或七氟烷浓度于0.7、1.0、1.3及1.5MAC,并各稳定15min后,描记脑电图。结果癫痫患者1.0MAC地氟烷时棘波的频率与0.7MAC时相比无明显变化,而1.3MAC和1.5MAC时棘波的频率明显低于0.7MAC时(P<0.01)。1.0MAC和1.3MAC七氟烷时棘波的频率与0.7MAC时相比无明显变化,而1.5MAC时棘波的频率明显高于0.7MAC时(P<0.05)。随着呼气末地氟烷或七氟烷浓度的升高,所有患者的α和β波逐渐减少,而δ波增多。结论癫痫手术用地氟烷维持麻醉,术中需行皮层脑电图监测时,将地氟烷麻醉深度维持于0.7～1.0MAC或七氟烷麻醉深度维持于0.7～1.3MAC较为适宜,以保证癫痫源灶准确的定位及指导手术切除的范围。Objective To compare the effect of desflurane and sevoflurane with different concentrations on the electroencephalogram（EEG） in epileptic patients. Methods 40 epileptic patients for epilepsy surgery were randomly divided into two groups： desflurane group（n=20） and sevoflurane group（n=20）. The changes of epidural EEG were observed during anesthesia with 0.7MAC, 1.0MAC, 1.3MAC and 1,5MAC desflurane and sevoflurane. Results The frequencies of spike （or sharp） waves were similar at 0,7MAC and 1.0MAC desflurane, and decreased significantly at 1.3MAC and 1.5MAC desflurane. The frequencies of spike （or sharp） waves were similar at 0.7MAC, 1.0MAC and 1.3MAC sevoflurane, and increased significantly at 1.5MAC sevoflurane. The frequencies of α and β waves decreased and δ wave increased with the increases of desflurane and sevoflurane concentration. Conclusions The maintenance of anesthesia with 0.7MAC-1.0MAC desflurane or 0.7MAC-1.3MAC sevoflurane is suitable for the epilepsy surgery with intraoperative EEG monitoring, which does not influence the activity of spike bursts.

关 键 词：癫痫 地氟烷 七氟烷 脑电图 皮层脑电图监测 癫痫患者 肺泡有效浓度 维持麻醉 麻醉深度 蒸发器刻度 

分 类 号：R651.1[医药卫生—外科学]