Parviainen Ilkka, Uusaro Ari, Kälviäinen Reetta, Mervaala Esa, Ruokonen Esko
Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.
Intensive Care Med. 2006 Jul;32(7):1075-9. doi: 10.1007/s00134-006-0154-1. Epub 2006 May 6.
To study prospectively the effects of propofol anesthesia on seizure control, hemodynamics and course of intensive care in patients with refractory status epilepticus.
Prospective observational study in the general intensive care unit in a tertiary university hospital.
Ten patients with refractory status epilepticus.
Patients received propofol anesthesia aiming to burst suppression EEG pattern for 12 h.
Dose of propofol, quality of burst suppression EEG, hemodynamics and the course of intensive care were recorded. Clinical and electrophysiological seizures terminated quickly, but maintaining burst suppression EEG pattern required incremental doses of propofol. Despite high doses of propofol, recovery from anesthesia was fast.
High doses of propofol are needed in the treatment of refractory status epilepticus. The maintenance of continuous-burst suppression is difficult, and vigilant titrating of dosage of propofol is necessary under continuous EEG monitoring.
前瞻性研究丙泊酚麻醉对难治性癫痫持续状态患者癫痫控制、血流动力学及重症监护病程的影响。
在一所三级大学医院的综合重症监护病房进行的前瞻性观察性研究。
10例难治性癫痫持续状态患者。
患者接受丙泊酚麻醉，目标是达到脑电图爆发抑制模式持续12小时。
记录丙泊酚剂量、脑电图爆发抑制质量、血流动力学及重症监护病程。临床和电生理癫痫发作迅速终止，但维持脑电图爆发抑制模式需要递增丙泊酚剂量。尽管使用了高剂量丙泊酚，麻醉恢复仍很快。
治疗难治性癫痫持续状态需要高剂量丙泊酚。维持持续爆发抑制困难，在持续脑电图监测下需谨慎滴定丙泊酚剂量。
