Aksu Recep, Kumandas Sefer, Akin Aynur, Bicer Cihangir, Gümüş Hakan, Güler Gülen, Per Hüseyin, Bayram Adnan, Boyaci Adem
Department of Anaesthesiology, Erciyes University Medical Faculty, Kayseri, Turkey.
Paediatr Anaesth. 2011 Apr;21(4):373-8. doi: 10.1111/j.1460-9592.2010.03516.x.
When electroencephalogram (EEG) activity is recorded for diagnostic purposes, the effects of sedative drugs on EEG activity should be minimal. This study compares the sedative efficacy and EEG effects of dexmedetomidine and midazolam.
EEG recordings of 60 pediatric subjects with a history of simple febrile convulsions were performed during physiologic sleep. All of these patients required sedation to obtain follow-up (control) EEGs. Subjects in Group D received 0.5 μg·kg(-1) of dexmedetomidine, and those in Group M received 0.1 mg·kg(-1) of midazolam. For rescue sedation, the same doses were repeated to maintain a Ramsey sedation score level of between 4 and 6.
The mean doses that were required for sedation were 0.76 μg·kg(-1) of dexmedetomidine and 0.38 mg·kg(-1) of midazolam. Diastolic blood pressure and HR were lower in Group D than in Group M (P < 0.05). Hypoxia was observed in 11 (36.7%) subjects in Group M and none in Group D; this was statistically significant (P < 0.001). Frontal and parieto-occipital (PO) EEG frequencies were similar during physiologic sleep and dexmedetomidine sedation. However, EEG frequencies in these areas (P < 0.001) and PO EEG amplitude (P = 0.030) were greater during midazolam sedation than during physiologic sleep.
Dexmedetomidine is a suitable agent to provide sedation for EEG recording in children. There is less change in EEG peak frequency and amplitude after dexmedetomidine than after midazolam sedation.
当记录脑电图（EEG）活动用于诊断目的时，镇静药物对EEG活动的影响应最小。本研究比较了右美托咪定和咪达唑仑的镇静效果及对EEG的影响。
对60例有单纯热性惊厥病史的儿科受试者在生理性睡眠期间进行EEG记录。所有这些患者都需要镇静以获得后续（对照）EEG。D组受试者接受0.5μg·kg⁻¹的右美托咪定，M组受试者接受0.1mg·kg⁻¹的咪达唑仑。对于补救性镇静，重复相同剂量以维持Ramsey镇静评分在4至6之间。
镇静所需的平均剂量为右美托咪定0.76μg·kg⁻¹和咪达唑仑0.38mg·kg⁻¹。D组的舒张压和心率低于M组（P<0.05）。M组11例（36.7%）受试者出现低氧，D组无；差异有统计学意义（P<0.001）。生理性睡眠和右美托咪定镇静期间额叶和顶枕（PO）EEG频率相似。然而，这些区域的EEG频率（P<0.001）和PO EEG波幅（P = 0.030）在咪达唑仑镇静期间高于生理性睡眠期间。
右美托咪定是为儿童EEG记录提供镇静的合适药物。右美托咪定镇静后EEG峰值频率和波幅的变化小于咪达唑仑镇静后。
