Zeiler Frederick A, Zeiler Kaitlin J, Teitelbaum Jeanne, Gillman Lawrence M, West Michael
1Section of Neurosurgery,Department of Surgery,University of Manitoba,Winnipeg,Canada.
2Section of Neurocritical Care,Montreal Neurological Institute,McGill,Montreal,Canada.
Can J Neurol Sci. 2015 Mar;42(2):106-15. doi: 10.1017/cjn.2014.121. Epub 2015 Jan 9.
Our goal was to perform a systematic review of the literature on the use of modern inhalational anesthetic agents for refractory status epilepticus and their impact on seizure control.
All articles from MEDLINE, BIOSIS, EMBASE, Global Health, HealthStar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to March 2014), reference lists of relevant articles, and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and Grading of Recommendation Assessment Development and Education methodology by two independent reviewers.
Overall, 19 studies were identified, with 16 manuscripts and 3 meeting abstracts. A total of 46 patients were treated. Adult (n=28) and pediatric patients (n=18) displayed 92.9% and 94.4% seizure control with treatment, respectively. Isoflurane was used in the majority of cases. Hypotension was the only complication described.
Oxford level 4, Grading of Recommendation Assessment Development and Education D evidence exists to support the use of isoflurane in refractory status epilepticus to obtain burst suppression. Insufficient data exist to comment on the efficacy of desflurane and xenon at this time.
我们的目标是对使用现代吸入性麻醉剂治疗难治性癫痫持续状态及其对癫痫控制影响的文献进行系统综述。
检索了MEDLINE、BIOSIS、EMBASE、Global Health、HealthStar、Scopus、Cochrane图书馆、国际临床试验注册平台（起始至2014年3月）的所有文章、相关文章的参考文献列表以及灰色文献。由两名独立审稿人使用牛津方法和推荐评估、制定与教育分级方法来判定证据的强度。
共识别出19项研究，包括16篇手稿和3篇会议摘要。总共治疗了46例患者。成人（n = 28）和儿科患者（n = 18）经治疗后癫痫控制率分别为92.9%和94.4%。大多数病例使用异氟烷。低血压是唯一描述的并发症。
有牛津4级、推荐评估、制定与教育分级D级证据支持在难治性癫痫持续状态中使用异氟烷以实现爆发抑制。目前关于地氟烷和氙气疗效的数据不足，无法进行评论。
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