皮层脑电图监测下癫痫病人手术治疗的麻醉处理  

Anesthesia treatment of the operation of epilepsy patients under the monitoring of electrocorticography

作　　者：杨明明 谢凡 聂颖 袁重阳 王在臣 巫宇丛 YANG Ming-ming;XIE Fan;NIE Ying;YUAN Chong-yang;WANG Zai-chen;WU Yu-cong(Department of Anethesiology,Guangdong 999 Brain Hospital,Guangzhou Guangdong 510510,China)

机构地区：[1]广东三九脑科医院麻醉科,广东广州510510

出　　处：《蚌埠医学院学报》2017年第9期1220-1222,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨皮层脑电图(ECo G)监测下癫痫病人手术治疗的麻醉方案及管理方法。方法:选择40例需行手术治疗的癫痫病人作为研究对象,随机分为静吸复合麻醉组(A组)和全静脉麻醉组(B组)。A组采用七氟烷静吸复合麻醉,B组采用丙泊酚靶控静脉麻醉,观察2组七氟烷吸入浓度及丙泊酚靶浓度分别为1.5最低肺泡有效浓度(MAC)或5.0μg/m L(T1)、1.0MAC或3.0μg/ML(T2)、0.5 MAC或1.5μg/m L(T3)时ECo G出现爆发性抑制波例数、术中棘波频率变化以及血流动力学变化情况。结果:在T2、T3时刻,2组癫痫手术过程中ECo G可准确描记癫痫波且血流动力学指标稳定。2组病人在T1时刻ECo G出现爆发抑制波的例数最多,随着麻醉药物浓度的降低,2组ECo G监测到的爆发抑制波出现次数逐渐减少。但在不同时刻,2组在血流动力学指标、爆发抑制波和棘波出现情况差异均无统计学意义(P>0.05)。结论:七氟烷与丙泊酚对癫痫病人ECo G的影响均呈剂量依赖型,但在一定麻醉深度下不影响ECo G对癫痫波的识别及病灶定位,可安全用于癫痫病灶切除手术麻醉。Objective:To explore the anesthetic plan and management of epilepsy patients under the monitoring of electrocorticography(ECoG).Methods:Forty epilepsy patients treated with surgery were randomly divided into the intravenous inhalation compound anesthesia group(group A)and total intravenous anesthesia group(group B).The group A and group B were treated with sevoflurane inhalation anesthesia and intravenous infusion of propofol target controlled,respectively.When the concentration of sevoflurane or propofol were1.5MAC or5.0μg/mL(T1),1.0MAC or3.0μg/mL(T2)and0.5MAC or1.5μg/mL(T3),the number of eruptive suppression wave,spike frequency and hemodynamic changes during operation were observed in the ECoG.Results:At T2and T3in two groups during operation,the ECoG could accurately record the epilepsy wave,and the hemodynamic index was stable.At T1,the number of eruptive suppression wave in ECoG were the most.At different time points,the differences of the hemodynamic index,number of eruptive suppression wave and spike frequency between two groups were not statistically significant(P>0.05).Conclusions:The effects of the sevoflurane and propofol on ECoG are dose dependent in epilepsy patients,but it does not affect the epilepsy wave identification and lesion location of ECoG under a certain depth of anesthesia,and can be safely used the anesthesia of epilepsy surgery.

关 键 词：癫痫 麻醉 皮层脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]