在彩色密度谱阵列监测下，对一名癫痫持续状态患者给予右美托咪定。
Dexmedetomidine administration in a patient with status epilepticus under color density spectral array monitoring.
作者信息
Obara Shinju, Kakinouchi Koh, Honda Jun, Noji Yoshie, Hanayama Chie, Murakawa Masahiro
机构信息
Surgical Operation Department, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Department of Anesthesiology, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
出版信息
JA Clin Rep. 2019 Feb 27;5(1):12. doi: 10.1186/s40981-019-0234-1.
BACKGROUND
Status epilepticus requires immediate treatment because treatment delay can cause permanent neurologic complications. Dexmedetomidine may be an option for the treatment of status epilepticus although its effect remains unclear with conflicting reports.
CASE PRESENTATION
A 64-year-old woman with epilepsy with complex partial seizures underwent total knee arthroplasty. After emergence from general anesthesia, she developed status epilepticus and was transferred to the intensive care unit. Following initial treatment using benzodiazepines, phenytoin, and levetiracetam, dexmedetomidine (0.37 μg/kg loading in 10 min followed by 0.6 μg/kg/h) was administered and seizures terminated in 20 min. Color density spectral array using Root® with SedLine® (Masimo, Irvine, CA, USA) showed an increase in power in high frequency band of the electroencephalogram during the seizure attacks.
CONCLUSION
We described a case of status epilepticus which was treated with dexmedetomidine and monitored using color density spectral array.
背景
癫痫持续状态需要立即治疗，因为治疗延迟可能导致永久性神经并发症。右美托咪定可能是治疗癫痫持续状态的一种选择，尽管其效果仍不明确，报道相互矛盾。
病例介绍
一名64岁患有复杂部分性发作癫痫的女性接受了全膝关节置换术。全身麻醉苏醒后，她发生了癫痫持续状态，并被转入重症监护病房。在使用苯二氮䓬类药物、苯妥英和左乙拉西坦进行初始治疗后，给予右美托咪定（10分钟内负荷剂量0.37μg/kg，随后0.6μg/kg/h），癫痫发作在20分钟内终止。使用带有SedLine®的Root®（美国加利福尼亚州欧文市Masimo公司）进行的彩色密度谱阵列显示，癫痫发作期间脑电图高频带功率增加。
结论
我们描述了一例用右美托咪定治疗并使用彩色密度谱阵列进行监测的癫痫持续状态病例。
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