七氟烷对癫痫和非癫痫病人脑电图的影响

目的对比观察不同呼气末七氟烷含量时癫痫及非癫痫病人脑电图及棘波的变化,以探讨癫痫手术中七氟烷维持麻醉的合适含量。方法20例癫痫需行手术治疗及15例非癫痫开颅手术病人,以1·0MAC七氟烷维持麻醉,术中置入硬膜外电极后,调整蒸发器刻度,分别控制呼气末七氟烷含量于0·7、1·0、1·3、1·5MAC,并各稳定15min后描记脑电图。结果癫痫病人1·0、1·3MAC七氟烷时棘波的频数与0·7MAC时相比无明显变化,而1·5MAC时棘波的频数明显高于0·7MAC时(P<0·05)。非癫痫病人在0·7、1·0及1·3MAC七氟烷时均无棘波出现,于1·5MAC时有5例出现棘波。随着呼气末七氟烷含量的升高所有病人的α和β波均逐渐减少,而δ波增多。结论癫痫手术用七氟烷维持麻醉,术中需行皮质脑电图监测时,将七氟烷含量维持于0·7~1·3MAC较为适宜,以保证癫痫源灶准确的定位及手术切除范围。

Effects of Sevoflurane on Electroencephalogram of Epileptic or Non-epileptic Patients

Objective To compare the effects of sevoflurane with different concentrations on the electroencephalogram(EEG) in epileptic or non-epileptic patients and investigate the suitable concentration of sevoflurane for epilepsy surgery.Methods The changes of epidural EEG were observed during anesthesia with 0.7, 1.0, 1.3 and 1.5 MAC sevoflurane in 20 epileptic patients undergoing epilepsy surgery and in 15 non-epileptic patients of neurosurgery.Results The frequencies of spike (or sharp) waves were similar at 0.7, 1.0 and 1.3 MAC, and increased significantly at 1.5 MAC in epileptic patients. No spike waves appeared at 0.7, 1.0 and 1.3 MAC and five cases showed spike bursts at 1.5 MAC in non-epileptic patients. The frequencies of α and β waves decreased and δ wave increased with the increases of sevoflurane concentration in both epileptic and non-epileptic patients.Conclusion The maintenance of anesthesia with 0.7～1.3 MAC sevoflurane is suitable for the epilepsy surgery with intraope-rative EEG monitoring, which does not influence the activity of spike bursts.