咪达唑仑术前喷鼻对儿童在七氟烷诱导期间癫痫样脑电图的影响

目的:评估咪达唑仑术前喷鼻对儿童在七氟烷诱导麻醉期间癫痫样放电的影响。方法 :将择期行全身麻醉下口腔颌面外科手术的86例患者(ASA分级Ⅰ~Ⅱ级,年龄0.5~6岁),随机分为咪达唑仑组和生理盐水组2组。患儿在等候区予以术前药物喷鼻,入室后以相同步骤行8%七氟烷面罩诱导,持续监测麻醉诱导期间脑电图改变。采用SPSS 25.0软件包对数据进行统计学分析。结果:咪达唑仑组23例(53%,包括DSP30%、PSR37%、PED9%)、生理盐水组29例(67%,包括DSP37%、PSR35%、PED19%)患儿发生癫痫样脑电图改变,2组癫痫样脑电图发生率无统计学差异(P=0.186)。咪达唑仑组意识丧失时间早于生理盐水组,但差异无显著性[(41.6±11.0)s∶(44.1±16.1)s,P=0.409]。结论:0.4 mg/kg咪达唑仑术前喷鼻并不能减少儿童在七氟烷诱导期间的癫痫样脑电图发生。

Effects of intranasal midazolam spray as premedication on epileptiform EEG in children during induction with sevoflurane

PURPOSE: This clinical trial was performed to evaluate the effects of intranasal midazolam spray as premedication on the incidence of epileptiform EEG activity during induction with sevoflurane in children. METHODS: Eighty-six patients(0.5-6 years, ASA Ⅰ-Ⅱ) undergoing elective oral and maxillofacial surgery under general anesthesia were randomly allocated to two different premedication groups: midazolam group and normal saline group. After intranasal premedication spray in the waiting area, the patients were transferred to the operating room. The patients were anesthetized with 8% sevoflurane via face mask. EEGs during induction were continuously recorded and analyzed. Statistical analysis was performed using SPSS 25 software package. RESULTS: Twenty-three patients (53%, DSP30%, PSR37%, PED9%) in midazolam group had epileptiform EEG patterns compared to 29 patients (67%, DSP37%, PSR35%, PED19%) in normal saline group (P=0.186). The time from start of sevoflurane until loss of consciousness was shorter in midazolam group than in normal saline group, but the difference was not significant [(41.6±11.0)s vs (44.1±16.1)s,P=0.409]. CONCLUSIONS: 0.4 mg/kg midazolam intranasal spray before operation can not reduce the occurrence of epileptiform EEG in children during sevoflurane induction.