在使用咪达唑仑和硫喷妥钠诱导麻醉后对儿童进行七氟烷麻醉不会引起癫痫样脑电图。

Sevoflurane anaesthesia in children after induction of anaesthesia with midazolam and thiopental does not cause epileptiform EEG.

作者信息

Nieminen K, Westerèn-Punnonen S, Kokki H, Yppärilä H, Hyvärinen A, Partanen J

机构信息

Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland.

出版信息

Br J Anaesth. 2002 Dec;89(6):853-6. doi: 10.1093/bja/aef290.

DOI:10.1093/bja/aef290

PMID:12453929

Abstract

BACKGROUND

Sevoflurane is a methyl ether anaesthetic commonly used for induction and maintenance of general anaesthesia in children. Sevoflurane is a non-irritant and acts quickly so induction is usually calm. However, inhalation induction with high concentrations of sevoflurane can cause convulsion-like movements and seizure-like changes in the electroencephalogram (EEG). Little is known about the EEG during maintenance of anaesthesia with sevoflurane, so we planned a prospective trial of sevoflurane maintenance after i.v. induction with benzodiazepine and barbiturate, which is another common induction technique in children.

METHODS

EEG recordings were made before premedication with midazolam (0.1 mg kg(-1) i.v.), during induction of anaesthesia with thiopental (5 mg kg(-1)), and during maintenance with sevoflurane (2% end-tidal concentration in air/oxygen without nitrous oxide) in 30 generally healthy, 3- to 8-year-old children having adenoids removed. Noise-free EEG data of good quality were successfully recorded from all 30 children.

RESULTS

Two independent neurophysiologists did not detect epileptiform discharges in any of the recordings.

CONCLUSION

Premedication with midazolam, i.v. induction with thiopental and maintenance of anaesthesia with 2% sevoflurane in air does not cause epileptiform EEG patterns in children.

摘要

背景

七氟醚是一种甲基醚类麻醉剂，常用于小儿全身麻醉的诱导和维持。七氟醚无刺激性且起效迅速，因此诱导过程通常较为平稳。然而，高浓度吸入七氟醚诱导可导致类似惊厥的动作以及脑电图（EEG）出现类似癫痫发作的变化。关于七氟醚维持麻醉期间的脑电图情况知之甚少，所以我们计划进行一项前瞻性试验，观察在静脉注射苯二氮䓬类药物和巴比妥类药物诱导后使用七氟醚维持麻醉的情况，这是小儿另一种常见的诱导技术。