右美托咪定对顽固性癫痫患者皮层脑电监测的影响  

Effect of dexmedetomidine on electrocorticogram mornitoring during anesthesia for refractory epilepsy patients

作　　者：刘晓军[1] 唐靖[1] 杨开军[2] 徐波涛[2] 王洪筱[2] 肖金仿[1] 

机构地区：[1]南方医科大学南方医院麻醉科,广州市510515 [2]南方医科大学南方医院神经外科,广州市510515

出　　处：《临床麻醉学杂志》2012年第7期678-680,共3页Journal of Clinical Anesthesiology

基　　金：广东省科技计划项目(2010A030400007);南方医大学南方医院院长基金项目(2010B003)

摘　　要：目的观察右美托咪定对顽固性癫痫患者术中皮层脑电(ECoG)监测的影响。方法 40例顽固性癫痫患者随机均分为右美托咪定组(D组)和咪达唑仑组(M组)。在开颅行ECoG电极探测定位致痫灶后,D组泵注右美托咪定1.0μg/kg的负荷剂量,M组泵注咪达唑仑0.04mg/kg,均泵注10min后再次行ECoG探测定位。记录两组患者药物泵注前(T_1)、泵注10min后(T_2)HR、MAP、BIS及给药前后ECoG中癫痫波频率及分布。结果两组给药前后ECoG确认的致痫灶一致。T_2时M组癫痫波频率明显少于T_1时及D组(P<0.05)。T_2时M组HR明显低于T_1时(P<0.05)。T_2时两组BIS均明显低于T_1时,且M组明显低于D组(P<0.05或P<0.01)。结论右美托咪定对癫痫波无明显抑制作用,对ECoG定位的影响较咪达唑仑小,二者均能使BIS降低。Objective To observe the effect of dexmedetomidine on electrocorticogram （ECoG） monitoring during anesthesia for refractory epilepsy patients. Methods Forty patients with refractory epilepsy were randomly divided into dexrnedetomidine group （group D） and midazolam group（group M）. After placing ECoG monitoring probes by following epileptiform waves, patients in group D were injected 1.0μg/kg of dexlnedetomidine, while group M were 0. 04 mg/kg of midazolam, and then ECoG was placed again 10 rain after injection of the drug. HR, MAP, BIS, frequency and distribution of epileptic waves were recorded before （T1） and 10 min after the drug administration （T2）. Results The epileptogenic locations were same at both time points. The frequency of epileptiform waves at T2 were lower than that at T1 and correspondingly in group D （P〈0.05）. BIS at T2 was lower than that at T1 in both groups, and t318 at T2 in group M was lower than that in group D （P〈0.05 or P〈0.01）. In group M, HR at T2 was slower than that of at T1 （P〈0.05）. Conclusion Dexmedetomidine do not suppress the epileptiform waves, and influence on locating ECoG was smaller than midazolam, both drugs reduce BIS value.

关 键 词：右美托咪定 咪达唑仑 顽固性癫痫 皮层脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]