Yamashita Koichi, Yokoyama Takeshi, Tokai Hirofumi, Imazu Yasuhiro, Lee Masakazu, Manabe Masanobu
Department of Anesthesiology and Resuscitology, Kochi Medical School, Nankoku 783-8505.
Masui. 2003 May;52(5):521-3.
A 39-year-old woman with multiple sclerosis (MS) at exacerbation stage underwent dilatation and curettage. MS is characterized by chronic inflammation, demyelination, and gliosis in the central nervous system. Surgical stress often induces exacerbation of MS symptoms. Therefore, deep anesthesia is required for anesthetic management in cases of MS. We monitored electroencephalograph (EEG), spectral edge frequency 90 (SEF 90), spectral median frequency (SMF) and delta-amplitude for depth of anesthesia using pEEG (Dräger, Germany). In this case, anesthesia was induced with sevoflurane and gradually increased to 5% in oxygen 4 l.min-1 and maintained with sevoflurane 2-3% in 2 nitrous oxide l.min-1 and 2 l.min-1 oxygen. Surgery was completed and no spike wave was observed by pEEG monitoring during surgery. In conclusion, sevoflurane anesthesia was useful for a patient with MS during exacerbation stage.
一名处于病情加重期的39岁多发性硬化症（MS）女性患者接受了刮宫术。MS的特征是中枢神经系统的慢性炎症、脱髓鞘和胶质增生。手术应激常诱发MS症状加重。因此，MS患者麻醉管理需要深度麻醉。我们使用脑电双频指数（pEEG，德国德尔格公司）监测脑电图（EEG）、90%频谱边缘频率（SEF 90）、频谱中位数频率（SMF）和δ波幅度以评估麻醉深度。该病例中，用七氟醚诱导麻醉，并逐渐增加至在4 l.min-1氧气中浓度为5%，然后维持在2 l.min-1氧化亚氮和2 l.min-1氧气中七氟醚浓度为2% - 3%。手术完成，术中pEEG监测未观察到棘波。总之，七氟醚麻醉对处于病情加重期的MS患者有效。
