[1]张兆斯　但　炜　王　刚　周　超　孙　超　谢延风　石全红　詹　彦.咪达唑仑和丙泊酚诱导麻醉对继发性癫痫术中皮层脑电图的影响[J].中国临床神经外科杂志,2016,(05):261-263.[doi:10.13798/j.issn.1009-153X.2016.05.002]
　ZHANG Zhao-si,DAN Wei,WANG Gang,et al.Effects of midazolam or propofol used for induction of anesthesia on intraoperative ECoG in patients with secondary epilepsy[J].,2016,(05):261-263.[doi:10.13798/j.issn.1009-153X.2016.05.002]
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咪达唑仑和丙泊酚诱导麻醉对继发性癫痫 术中皮层脑电图的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年05期
页码:
261-263
栏目:
论著
出版日期:
2016-05-25

文章信息/Info

Title:
Effects of midazolam or propofol used for induction of anesthesia on intraoperative ECoG in patients with secondary epilepsy
文章编号:
1009-153X（2016）05-0261-03
作者:
张兆斯　但　炜　王　刚　周　超　孙　超　谢延风　石全红　詹　彦
作者单位：400016 重庆，重庆医科大学附属第一医院神经外科（张兆斯、但 炜、王　刚、周　超、孙　超、谢延风、石全红、詹　彦）
Author(s):
ZHANG Zhao-si;  DAN Wei;  WANG Gang;  ZHOU Chao;  SUN Chao;  XIE Yan-feng;  SHI Quan-hong;  ZHAN Yan
Department of Neurosurgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
关键词:
继发性癫痫; 显微手术; 麻醉诱导; 咪达唑仑; 丙泊酚; 暴发抑制现象; 皮层脑电图
Keywords:
Induction of anesthesia;  Midazolam;  Propofol;  Secondary epilepsy;  Burst suppression;  Electrocorticography
分类号:
R 742.1; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.05.002
文献标志码:
A
摘要:
目的 探讨咪达唑仑与丙泊酚诱导麻醉对继发性癫痫术中皮层脑电图（ECoG）的影响。方法 2013年6月至2015年9月收治非功能区占位性病变继发性癫痫180例，根据诱导麻醉方法分为咪达唑仑组（60例；0.2 mg/kg）、丙泊酚组（60例；2 mg/kg）和咪达唑仑+丙泊酚组[60例；咪达唑仑（0.05 mg/kg）+丙泊酚（1 mg/kg）]。打开硬膜后行第一次ECoG监护，病灶切除后行第二次ECoG监护。结果 从麻醉诱导至第一次监护的时间为（110.3±15.9）min。第一次ECoG监护显示，咪达唑仑组暴发抑制（BS）波形发生率（68.3%，41/60）明显高于丙泊酚组（25.0%，15/60；PP<0.05），后两组之间无统计学差异（>P>0.05）。麻醉诱导至第一次监护时间≤120 min时，咪达唑仑组BS发生率均明显高于丙泊酚组（P<0.05）和咪达唑仑+丙泊酚组（>P<0.05）；>120 min时，3组BS发生率无统计学差异（P>0.05）。第二次ECoG监护显示，咪达唑仑组、丙泊酚组和咪达唑仑+丙泊酚组BS发生率分别为5.0%（3/60）、3.3%（2/60）和3.3%（2/30），3组之间无统计学差异（P>0.05）。结论 继发性癫痫患者术前镇静类诱导麻醉用药宜选用小剂量咪达唑仑联合丙泊酚。
Abstract:
Objective To explore the option of sedating narcotics during the induction of anesthesia in patients with secondary epilepsy undergoing surgery. Methods One hundred and eighty patients with secondary epilepsy were divided into 3 groups of 60 patients each, i.e. group A in which midazolam (0.2 mg/kg) was intravenously injected, group B in which propofol (2 mg/kg) was intravenously injected and group C in which midazolam (0.05 mg/kg) and propofol (1 mg/kg) were intravenously injected before the surgery. The first electrocorticograph (ECoG 1) was detected before the resection of the lesion and the second ECoG (ECoG 2) was detected after the resection of the lesion. The rates of burst suppression (BS) occurrence during the different periods were compared among 3 groups. Results ①The BS occurrence rate (68.3%) in ECoG 1 was significantly higher in group A than those (25.0%) and (28.3%) respectively in group B and group C (PP<0.05). there="" was="" insignificant="" difference="" in="" bs="" occurrence="" rate="" over="" two="" hours="" after="" the="" beginning="" of="" detection="" ecog="" 1="" and="" 2="" (P>0.05). Conclusions The small dose of both midazolam and propofol for the induction of anesthesia should be selected in the patients with secondary epilepsy undergoing surgery.

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更新日期/Last Update: 2016-05-30