摘要
目的比较不同麻醉方法在癫痫病灶切除术中的麻醉效果以及对术中皮质脑电监测(ECoG)的影响。方法 90例颞叶癫痫患者,随机分为3组,分别采用瑞芬太尼-丙泊酚靶控输注(TCI)全凭静脉麻醉(Ⅰ组)、全凭吸入七氟醚麻醉组(Ⅱ组)及静吸复合麻醉(Ⅲ组)。观察不同麻醉方法的麻醉效果,以及对皮质脑电(ECoG)监测定位的影响。结果 3组患者时点MAP、HR组间比较差异无统计学意义。组ⅠECoG可检测时间、自主呼吸恢复时间和术毕清醒时间均较组Ⅱ、组Ⅲ短,差异有统计学意义。组Ⅰ对ECoG影响不明显,而组ⅡECoG的棘波、α波、β波及δ波的每秒连续波形数多有明显减少,与组Ⅰ相比差异有统计学意义。与组Ⅰ相比,组Ⅲ患者ECoG的α波、β波的每秒连续波形数减少,差异有统计学意义。结论合适的靶浓度瑞芬太尼复合丙泊酚TCI是术中ECoG指导下癫痫病灶切除手术患者麻醉的良好选择。术中患者生命体征平稳,易于调控,不干扰ECoG的监测,术后清醒完全而迅速,对术后需要神经学检查的患者更有优势。
Objective To compare the anaesthesia effect and the effect of the exact localization with different anesthesia methods in lumpectomy with pinpointing the focus of epilepsy. Methods Ninty patients with temporal lobe epilepsy （aged-years, ASAI-II）scheduled for epilepsy loci resection with electrocoticography （ECoG） were randomly assigned to three groups including those receiving remifentanil-propofol TCI intravenous anesthesia （group I）, sevoflurane inhalation anesthesia （groupll） and sevoflurane combined propofol and remifentanil anesthesia （group Ⅲ） . Anesthesia effect and the effect of the exact localization with different anesthesia methods in the epilepsy loci resection were observed. Results HR and MAP of three groups at every time point were not significant changed, the time of detectable electrocorticography, spontaneous breathing recovery and eye opening in group I was significantly shorter than that in group Ⅱ and group Ⅲ. The wave of ECoG in group I was not significant changed, but the frequencies of spike wave, αwave , β wave and δwave in group Ⅱ were reduced significantly compared to those in group I. The frequencies ofαwave andβwave in group Ⅲ were reduced significantly compared to those in group I. Conclusion TCI of remifentanil-propofol can be used as a good choice of anesthesia for the patients undergoing epileptic loci resection . It could keep anesthesia smoothly, speed up but not disturb electrocorticography detection, and make patients quickly and completely recover from anesthesia.
出处
《临床神经外科杂志》
CAS
2013年第3期174-175,178,共3页
Journal of Clinical Neurosurgery
