摘要
目的研究脑电监测期丙泊酚个体化用药对癫痫术中脑皮层电图(electrocorticography,ECoG)监测和术毕清醒时间的影响。方法选择择期行癫痫病灶切除术的患者60例,均采用丙泊酚靶控输注,丙泊酚靶浓度为3μg/ml,诱导时记录患者意识消失时效应室浓度(calculated effect site concentration at loss of consciousness,CeLOC)。切开硬脑膜后随机分成两组(每组30例),对照组丙泊酚靶控输注浓度降至1.5μg/ml联合泵入右美托咪定,负荷量0.5μg/kg,输注15min,继以0.5μg/(kg·h)维持输注;实验组丙泊酚靶控输注浓度降至CeLOC维持。术中ECoG监测结束将丙泊酚靶控输注浓度调回至3μg/ml,对照组停止右美托咪定输注。观察两组用药方案对ECoG监测的影响、术中知晓情况以及术毕清醒时间。结果两组用药剂量均不影响术中ECoG监测,均无术中知晓。术毕清醒时间实验组较对照组明显缩短(P<0.05)。结论采用麻醉诱导期患者CeLOC作为术中ECoG监测的个体化用药剂量,既无术中知晓,又不影响ECoG监测,术后清醒快,简化了麻醉用药,可安全用于致痫灶切除术的麻醉。
Objective To analyze the influence of personalized medicine for propofol on electrocorticography（ECoG）monitoring and emetgence time of epileptic patients.Methods A total of 60 epileptic patients who had underwent epileptic resection were collected.All patients were given propofol with blood concentration of 3μg/ml,and the calculated effect site concentration at loss of consciousness（CeLOC）were reported.After exposure of the cortex,these 60 patients were randomly devided into control group and experimental group,each group with 30 patients.In control group,the propofol blood concentrations were reduced to 1.5μg/ml,meanwhile,the dexmedetomidine was injected with a loading dose of 0.5μg/ml,then followed by a speed of 0.5μg/（kg·h）.In experimental group,the propofol blood concentrations were reduced to CeLOC.The propofol blood concentration was adjusted up to 3μg/ml in both groups when ECoG monitor stopped,and stopping the infusion of dexmedetomidine.The ECoG changes,intraoperative awareness,emetgence time of two groups were observed.Results ECoG were not affected in both groups,and all patients had no intraoperative awareness.Compared with control group,the emetgence time was shortened（P〈0.05）.Conclusion The CeLOC of propofol as the personalized medicine dosage have no intraoperative awareness and no influence on ECoG monitoring,patients wake up quickly,and can simplify the use of anesthesia.It is safe to be used for general anesthesia of epilepsy surgery.
作者
钟强
黄建成
蔡铁良
沈七襄
姚一
ZHONG Qiang , HUANG Jiancheng , CAI Tieliang , YAO Yi , SHEN Qixiang.(Department of Anesthesiology, Cheng- gong Hospital Affiliated to Xiamen University, Xiamen Fujian 361003, Chin)
出处
《华南国防医学杂志》
CAS
2018年第3期165-168,共4页
Military Medical Journal of South China
基金
全区医药卫生科研基金课题(ZD26)
关键词
癫痫
丙泊酚
靶控输注
术中脑皮层电图
Epilepsy
Propofol
Target controlled infusion
Intraoperative electrocorticography
