深部脑电图在七氟醚麻醉条件下的癎样放电波幅变异

Amplitude variety of epileptiform discharge with sevoflurane on depth electrode EEG

目的：比较七氟醚在不同麻醉深度下对颞叶癫癎手术术中深部电极描记的EEG的影响。方法：颞叶癫癎行射频热凝毁损手术患者68例，在七氟醚吸入麻醉，最小肺泡浓度（MAC）=0．6时监测额叶皮质EEG和颞叶深部EEG，再加深麻醉至MAC=1．2时再监测。EEG数据应用快速傅里叶处理（FFT），计算额叶背景平均波幅，测量10个颞叶内侧棘波的波幅，取平均值后确定为该患者的棘波波幅，对MAC=0．6和MAC=1．2两组进行统计。结果：MAC=0．6时颞叶内侧棘波放电波幅平均为（425．2±63．1）μV，额叶10～12Hz（80．3±16．4）μV背景波幅显著；MAC=1．2时颞叶内侧棘波放电波幅平均为（171．2±32．6）μV，额叶10～12Hz（550．3±126．8）μV背景波幅显著，两组间的癎样放电波幅和额叶背景波幅比较差异均有统计学意义（P〈0．05）。MAC≤1．2时，七氟醚吸入麻醉影响背景节律和痢样放电的波幅，对频率和波形无明显影响。结论：七氟醚麻醉对深部电极EEG的影响呈剂量依赖性，麻醉过深则可能导致痫样放电鉴别困难。

Objective：To study the effect of sevof!urane on depth electrode at different degrees of amplitude. Methods：Sixty-eight patients with temporal epilepsy undergoing epileptic loci radiofrequeney lesion were successively anaesthetized with sevoflurane on MAC of 0.6 and MAC of 1.2. The depth EEG of frontal lobe cortex and mesial temporal lobe cortex were recorded respectively. The data of ECoG and EEG of frontal lobe cortex were operated with fast Fourier transform（FFT）,with which the background average amplitudes of frontal lobe were measured. The average amplitude data of ten mesial temporal lobe epileptiform discharges in each patient were measured. The statistical treatment was operated on the data of two groups with MAC= 0.6 and MAC= 1.2 in each patient. Results： As MAC= 0.6, the average amplitude of mesial temporal lobe epileptiform discharge was 426.2±63.1μV, and the average amplitude of frontal lobe background was 80.3±16.4 μV with frequency of 10-12 Hz. As MAC=1 2, the average amplitude of mesial temporal lobe epileptiform discharges was 171.2±32.6 μV （P〈0. 05） , and the average amplitude of frontal lobe background was 550.3±126.8 μV （P〈0. 05） with frequency of 10-12 Hz. As MAC=1. 2, the sevoflurane inhalation could change the amplitudes of background and epileptiform discharge, and the frequency and pattern were not influenced by the sevoflurane inhalation. Conclusion;The effects of sevoflurane on depth EEG of patients with epilepsy show dose dependence, and the overdose of sevoflurane can make epileptiform discharge difficult to discriminate.