Department of Neuroanaesthesiology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
Seizure. 2012 Sep;21(7):501-7. doi: 10.1016/j.seizure.2012.05.002. Epub 2012 May 23.
It is well known that general anesthetics suppress/alter electrocorticography (ECoG) activity. However there are no randomized studies available, comparing various anesthetic techniques as regards their effects on ECoG.
The following is a double blind, randomized cross over study to compare the effects of isoflurane and propofol with or without nitrous oxide on electrocorticographic activity in patients undergoing epilepsy surgery. 40 patients suffering from medically intractable epilepsy scheduled to undergo resective surgery under ECoG guidance under general anesthesia, (March 2008-December 2010) were enrolled. Patients received either isoflurane or propofol (with air/oxygen or nitrous oxide/oxygen) as maintenance agents as per randomization and ECoG was recorded and quantified as per a scoring system (range 1-5, where 5 is most abnormal).
The mean ECoG score in isoflurane group and propofol with nitrous oxide was 3.0(1.2), 3.2(1.2) [p=0.7] and with air was 3.9(1.0) and 3.4(1.1) [p=0.1] respectively. In both isoflurane group and propofol group addition of nitrous oxide depressed the ECoG score (p ≤ 0.01, 0.5 respectively). The total duration of anesthesia, surgery, emergence time, extubation time, and hospital stay was comparable in two groups.
In our study optimal ECoG recordings were possible with use of either isoflurane or propofol. Addition of nitrous oxide to either of the anesthetic regimens suppressed the ECoG score.
众所周知，全身麻醉会抑制/改变脑电图（ECoG）活动。然而，目前尚无随机研究比较各种麻醉技术对 ECoG 的影响。
这是一项双盲、随机交叉研究，旨在比较异氟烷和丙泊酚联合或不联合一氧化二氮对接受脑电图引导下癫痫手术患者的脑电图活动的影响。共纳入 40 例接受全身麻醉下脑电图引导下切除术的药物难治性癫痫患者（2008 年 3 月至 2010 年 12 月）。根据随机分组，患者接受异氟烷或丙泊酚（空气/氧气或一氧化二氮/氧气）作为维持药物，记录脑电图并根据评分系统进行量化（范围 1-5，其中 5 表示最异常）。
异氟烷组和丙泊酚联合一氧化二氮组的平均脑电图评分分别为 3.0（1.2）、3.2（1.2）（p=0.7），与空气组的 3.9（1.0）和 3.4（1.1）相比，差异无统计学意义（p=0.1）。异氟烷组和丙泊酚组中，添加一氧化二氮均降低了脑电图评分（p≤0.01 和 0.5，分别）。两组的麻醉总时间、手术时间、苏醒时间、拔管时间和住院时间无差异。
在我们的研究中，使用异氟烷或丙泊酚均可获得最佳的脑电图记录。在任何一种麻醉方案中添加一氧化二氮均可抑制脑电图评分。
