地氟醚对癫痫和非癫痫病人脑电图的影响  

Effects of desflurane on electroencephalogram of epileptic or non-epileptic patients

作　　者：吉勇[1] 高旻[1] 王保国[1] 白勤[1] 王爱东[1] 

机构地区：[1]中国医学科学院首都医科大学附属北京天坛医院麻醉科,北京市100050

出　　处：《临床麻醉学杂志》2006年第10期749-751,共3页Journal of Clinical Anesthesiology

摘　　要：目的 对比观察不同呼气末地氟醚浓度时癫痫及非癫痫病人脑电图及棘波的变化。方法 20例癫痫需行手术治疗及15例非癫痫开颅手术病人，以浓度1．0MAC的地氟醚维持麻醉，术中置人硬膜外电极后，调整蒸发器刻度，分别控制呼气末地氟醚浓度于0．7、1．0、1．3及1．5MAC，并各稳定15min后描记脑电图。结果 癫痫病人1．0MAC地氟醚时棘波的频率与0．7MAC时相比无明显变化，而1．3和1．5MAC时棘波的频率明显少于0．7MAC时（P〈0．01）。非癫痫病人在0．7、1．0、1．3及1．5MAC地氟醚时均无棘波出现。随着呼气末地氟醚浓度的升高，所有病人的α和β波逐渐减少，而6波增多。结论 癫痫手术用地氟醚维持麻醉，术中需行皮层脑电图监测时，将地氟醚麻醉深度维持于0．7～1．0MAC较为适宜，以保证癫痫源灶准确的定位及手术切除范围。Objective To compare the effect of desflurane with different MAC on electroencephalogram （EEG） in epileptic or non-epileptic patients. Methods The changes of epidural EEG were observed during anesthesia with 0.7, 1.0, 1.3 or 1.5 MAC desflurane in 20 epileptic patients undergoing epilepsy surgery and in 15 non-epileptic patients of neurosurgery. Results The frequencies of spike （or sharp） waves were similar at 0.7 or 1.0 MAC,and decreased significantly at 1.3 or 1.5 MAC in epileptic patients. No spike waves appeared at 0.7,1.0,1.3 or 1.5 MAC in non-epileptic patients. The frequencies of α- and β waves decreased and δ wave increased with the increases of desflurane concentration in both epileptic and non-epileptic patients. Conclusion The maintenance of anesthesia with 0.7-1.0 MAC desflurane is suitable for the epilepsy surgery with intraoperative EEG monitoring,which does not effect on the activity of spike bursts.

关 键 词：神经外科手术 癫痫 地氟醚 脑电图 

分 类 号：R614[医药卫生—麻醉学]