Koyama Shinichi, Makino Yuriko, Tanaka Kazuo, Morino Michiharu, Nishikawa Kiyonobu, Asada Akira
Department of Anesthesiology, Osaka City University Medical School, Osaka 545-8586.
Masui. 2002 Jul;51(7):755-8.
A 36-year-old man with intractable epileptic seizures underwent insertion of subdural electrodes on bilateral temporal lobes under air-oxygen-sevoflurane anesthesia. After the completion of the operation, we measured electrocorticogram at end-tidal sevoflurane concentration of 2.5%, 1.5%, and 1.5% with 0.1 mg intravenous fentanyl. When sevoflurane concentration was reduced to 1.5%, the incidence and voltage of the spike waves on electrocorticogram were reduced. When 0.1 mg fentanyl was intravenously administrated during 1.5% sevoflurane anesthesia, the frequency of the spike waves was further reduced. Caution should be taken when using sevoflurane-fentanyl anesthesia because this combination may interrupt identification of epileptic focus on intraoperative electrocorticogram.
一名患有顽固性癫痫发作的36岁男性在空气-氧气-七氟醚麻醉下于双侧颞叶插入硬膜下电极。手术结束后,我们在呼气末七氟醚浓度为2.5%、1.5%以及1.5%并静脉注射0.1 mg芬太尼的情况下测量了皮质电图。当七氟醚浓度降至1.5%时,皮质电图上棘波的发生率和电压降低。在1.5%七氟醚麻醉期间静脉注射0.1 mg芬太尼时,棘波频率进一步降低。使用七氟醚-芬太尼麻醉时应谨慎,因为这种组合可能会干扰术中皮质电图对癫痫病灶的识别。