七氟醚与丙泊酚对癫痫手术患者皮层脑电图的影响

Effects of propofol and sevoflurane on electrocorticogram during epileptic surgery

目的比较不同麻醉深度下七氟醚与丙泊酚对癫痫手术术中皮层脑电图(ECoG)的影响。方法癫痫手术患者30例,随机均分为七氟醚吸入麻醉组(S组)和丙泊酚靶控静脉麻醉组(P组)。观察七氟醚吸入浓度或丙泊酚靶浓度分别为1.5 MAC或4.5μg/ml、1.0 MAC或3.0μg/ml、0.5 MAC或1.5μg/ml时的ECoG变化。结果 S组七氟醚吸入浓度在1 MAC以下,P组丙泊酚靶浓度在3.0μg/ml以下时不影响术中ECoG的定位,可准确描记到癫痫波。增加七氟醚吸入浓度或丙泊酚靶浓度均表现为α波及β波减少,δ波增加,癫痫波较浅麻醉时有所抑制。结论七氟醚和丙泊酚对癫痫患者ECoG的影响呈剂量依赖性,在一定麻醉深度下不影响ECoG对癫痫波的描记,可安全用于癫痫手术患者的麻醉。

Objective To study the effects of propofol and sevoflurane on electrocorticography（ECoG） at different depths of anesthesia.Methods Thirty patients with epilepsy undergoing epileptic foci resection were randomly allocated to receiving intravenous target-controlled-infusion（TCI） of propofol（group P） and sevoflurane inhalation（group S）.The changes of ECoG were observed during anesthesia with sevoflurane 1.5,1.0,0.5 MAC or TCI propofol 4.5,3.0,1.5 μg/ml.Respiration,circulation,revival time and complication were monitored.Results The sevoflurane inhalation below 1 MAC or TCI propofol below 3.0 μg/ml did not affect the positioning of ECoG.As the concentrations of sevoflurane inhalation and TCI propofol increased,α and β waves on ECoG decreased and δ wave increased and epilepsy waves were suppressed.Conclusion The effects of sevoflurane and propofol on ECoG in patients with epilepsy were dose-dependent.In certain depth of anesthesia,both of sevoflurane and propofol do not affect ECoG during epileptic surgery.