双侧 Wada 试验：戊巴比妥钠还是丙泊酚？
Bilateral Wada test: amobarbital or propofol?
机构信息
Service de Neurologie et d'Explorations Fonctionnelles Neurologiques, Unité "Chirurgie de l'épilepsie", Centre Hospitalier Universitaire de Toulouse, Hôpital Rangueil, 1 avenue du Pr Jean Poulhès TSA 50032, 31059 Toulouse, France; CERCO - Centre de Recherche Cerveau et Cognition UMR 5549 - CNRS (Centre National de la Recherche Scientifique), Pavillon Baudot, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Place du Dr Baylac, 31059 Toulouse, France.
Service de Neurologie et d'Explorations Fonctionnelles Neurologiques, Unité "Chirurgie de l'épilepsie", Centre Hospitalier Universitaire de Toulouse, Hôpital Rangueil, 1 avenue du Pr Jean Poulhès TSA 50032, 31059 Toulouse, France.
出版信息
Seizure. 2014 Feb;23(2):122-8. doi: 10.1016/j.seizure.2013.10.009. Epub 2013 Oct 26.
PURPOSE
The Wada test is still the gold standard procedure to predict language and memory deficits before temporal lobe epilepsy surgery. As amobarbital was no longer available, our aim was to validate propofol as an alternative.
METHOD
We retrospectively studied 47 patients who underwent a bilateral intracarotid procedure, performed with amobarbital (18), or propofol (29), between 2000 and 2010 during the preoperative evaluation of temporal lobe epilepsy.
RESULTS
The number of patients experiencing an adverse event (mostly transient disturbance of consciousness or benign ocular symptoms) during both injections did not differ significantly between amobarbital and propofol. Hemispheric dominance was successfully determined in 96.5% patients with propofol vs. 94.4% with amobarbital for language, and in 72.4% under propofol vs. 77.7% under amobarbital for memory with no significant difference between groups.
CONCLUSION
Propofol can be used for the Wada test with an efficacy and safety comparable to amobarbital.
目的
在进行颞叶癫痫手术前，Wada 测试仍然是预测语言和记忆缺陷的金标准程序。由于戊巴比妥不再可用，我们的目的是验证丙泊酚作为替代药物。
方法
我们回顾性研究了 47 名患者，他们在 2000 年至 2010 年期间接受了双侧颈内动脉注射，其中 18 名患者使用戊巴比妥，29 名患者使用丙泊酚，用于颞叶癫痫的术前评估。
结果
在两次注射过程中，出现不良反应（主要为短暂意识障碍或良性眼部症状）的患者数量在戊巴比妥和丙泊酚之间无显著差异。丙泊酚在语言方面成功确定优势半球的比例为 96.5%，戊巴比妥为 94.4%，在记忆方面分别为 72.4%和 77.7%，两组之间无显著差异。
结论
丙泊酚可用于 Wada 测试，其功效和安全性可与戊巴比妥相媲美。
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