将阿拉里斯听觉诱发电位监测仪作为电休克治疗期间癫痫诱发可能性及发作持续时间的指标：一项观察性研究。

The Alaris auditory evoked potential monitor as an indicator of seizure inducibility and duration during electroconvulsive therapy: an observational study.

作者信息

Huang Hsing-Hao, Wu Chun-Yu, Lin Feng-Sheng, Wang Yi-Ping, Sun Wei-Zen, Lin Chih-Peng, Fan Shou-Zen

机构信息

Department of Anesthesiology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan.

Department of Anesthesiology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan ; Department of Pharmacology, College of Medicine, National Taiwan University, No. 1 Sec. 1, Jen-Ai Road, Taipei 100, Taiwan.

出版信息

BMC Anesthesiol. 2014 May 13;14:34. doi: 10.1186/1471-2253-14-34. eCollection 2014.

DOI:10.1186/1471-2253-14-34

PMID:24914401

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4049489/

Abstract

BACKGROUND

Precise control of anesthetic depth during electroconvulsive therapy (ECT) is crucial because most intravenous anesthetics have anticonvulsant effects. In this study, we investigated the association between anesthetic depth measured by the Alaris auditory evoked potential index (AAI) and seizure inducibility and seizure duration during ECT.

METHODS

Sixty-four ECTs were evaluated in 12 consecutive patients. General anesthesia was performed with a thiopental-based method. The relationship between the pre-ictal AAI, seizure activity and seizure duration was analyzed, and a possible threshold pre-ictal AAI to induce a seizure duration of at least 25 seconds was calculated.

RESULTS

Forty-one of the 64 ECT stimuli successfully induced seizure activity that lasted longer than 25 seconds. Pre-ictal AAI was significantly correlated to seizure duration (r = 0.54, p < 0.001) and the threshold pre-ictal AAi value was calculated to be 26 (area under curve: 0.76, sensitivity: 70.3% and specificity: 73.9%, p < 0.001). ECT with a pre-ictal AAI ≧ 26 had a higher incidence of successful seizure activity ( p < 0.001) and a longer seizure duration (55 ± 35 v.s. 21 ± 27 seconds, p < 0.001).

CONCLUSION

Maintenance of a pre-ictal AAI value ≧ 26 was associated with an increased incidence of successful seizure activities and a longer seizure duration. This is the first report to investigate Alaris AEP monitoring during ECT.

摘要

背景

在电休克治疗（ECT）期间精确控制麻醉深度至关重要，因为大多数静脉麻醉药具有抗惊厥作用。在本研究中，我们调查了通过阿拉瑞斯听觉诱发电位指数（AAI）测量的麻醉深度与ECT期间癫痫发作诱导性和发作持续时间之间的关联。

方法

对12例连续患者的64次ECT进行了评估。采用基于硫喷妥钠的方法实施全身麻醉。分析发作前AAI、癫痫活动和发作持续时间之间的关系，并计算出诱导至少25秒发作持续时间的可能发作前AAI阈值。

结果

64次ECT刺激中有41次成功诱发了持续超过25秒的癫痫活动。发作前AAI与发作持续时间显著相关（r = 0.54，p < 0.001），计算出的发作前AAi阈值为26（曲线下面积：0.76，敏感性：70.3%，特异性：73.9%，p < 0.001）。发作前AAI≥26的ECT成功癫痫活动发生率更高（p < 0.001），发作持续时间更长（55±35对21±27秒，p < 0.001）。