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快速七氟醚麻醉诱导引起的癫痫样和周期性 EEG 活动。

Epileptiform and periodic EEG activities induced by rapid sevoflurane anaesthesia induction.

机构信息

Department of Anesthesiology, Medical Reserch Center (MRC), Oulu University Hospital and University of Oulu, Finland.

Department of Clinical Neurophysiology, MRC, Oulu University Hospital and University of Oulu, Finland.

出版信息

Clin Neurophysiol. 2018 Mar;129(3):638-645. doi: 10.1016/j.clinph.2017.12.037. Epub 2018 Jan 11.

Abstract

OBJECTIVES

The aim of the study was to compare the EEG findings and haemodynamic parameters of adult male patients while undergoing mask induction with sevoflurane anaesthesia with either controlled hyperventilation (CH) or spontaneous breathing (SB).

METHODS

Twenty male patients, aged 23-52 (mean 42) years were anaesthetized randomly with either spontaneous breathing or mild controlled hyperventilation via mask. EEG was recorded using a full 10-20 electrode set.

RESULTS

Anaesthesia induction with high inhaled concentrations of sevoflurane produced several epileptiform and periodic EEG patterns. CH doubled the amount of these EEG patterns compared to SB. Higher heart rate was recorded in the CH group.

CONCLUSIONS

We describe a high incidence of paroxysmal EEG activity: epileptiform and generalized periodic discharges (GPDs) during rapid sevoflurane in nitrous oxide-oxygen mask induction in hyperventilated male patients. However these activities have no effect to the heart rate or the mean arterial pressure.

SIGNIFICANCE

The monitoring of GPDs and burst suppression patterns during rapid anaesthesia induction with sevoflurane provides possibility to study the effects of volatile anaesthetics in the healthy brain. In order to analyse the different sources of EEG patterns a wide-band multichannel EEG recording is necessary.

摘要

目的

本研究旨在比较行七氟醚麻醉面罩诱导时,成人男性患者接受控制性过度通气(CH)或自主呼吸(SB)时的脑电图(EEG)表现和血流动力学参数。

方法

20 名年龄 23-52 岁(平均 42 岁)的男性患者随机接受自主呼吸或轻度控制性过度通气面罩通气。使用全 10-20 电极系统记录 EEG。

结果

高吸入浓度七氟醚诱导麻醉会产生几种癫痫样和周期性 EEG 模式。与 SB 相比,CH 使这些 EEG 模式的数量增加了一倍。CH 组的心率更高。

结论

我们描述了一种高发生率的阵发性 EEG 活动:在男性患者过度通气的氧化亚氮-氧气面罩诱导下,快速七氟醚麻醉时出现癫痫样和广泛周期性放电(GPD)。然而,这些活动对心率或平均动脉压没有影响。

意义

在使用七氟醚进行快速麻醉诱导期间监测 GPD 和爆发抑制模式,为研究挥发性麻醉剂对健康大脑的影响提供了可能。为了分析 EEG 模式的不同来源,需要进行宽带多通道 EEG 记录。

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