【摘要】 目的探讨难治性癫痫外科手术合理的麻醉方法方法１８例难治性癫痫患者随机分为３组：Ａ组４例麻醉维持以５０％Ｎ２Ｏ＋２ＭＡＣ安氟醚吸入并辅以大剂量芬太尼（１０～１５μｇ·ｋｇ－１）和维库溴铵１～２μｇ·ｋｇ－１·ｍｉｎ－１。Ｂ组５例以大于１．５ ＭＡＣ异氟醚吸入，余同Ａ组。Ｃ组３９例以小于１ＭＡＣ异氟醚＋５０％Ｎ２Ｏ吸入。辅以小剂量芬太尼（＜１０μｇ·ｋｇ－１），合同上。全部病例均常规监测皮层脑电图（ＣＥＥＧ）。结果Ａ组和Ｂ组分别有７５％和４０％出现ＣＥＥＧ 描记失真，Ｃ 组仅７．７％出现ＣＥＥＧ 描记失真．９２．３％不影响ＣＥＥＧ描记。结论低浓度异氟醚＋ ５０％Ｎ２Ｏ吸入，辅以小剂量芬大尼和肌松药既能提供适当的麻醉深度，又不抑制癫痫皮层脑电图棘慢波的出现；满足手术要求。更多还原

【Abstract】 Objective To study the rational methods of anesthesia on surgery with refractory epilepsy. Methods Fourly-eight patients with refractory epilepsy were divided randomly into three groups: Anesthesia was induced repectively with 30 % N2O + 2 MAC of enflurane + 10~ 15 μg. kg-1 fentany + 1- 2 μg’ kg-1 min vecuronum in group A (4 cases), with more than 1. 5MAC of isoflurane+ 50% N,O+ 10~ 15 μg’ kg-1 fentany1 + 1 ~ 2 ug· kg-1 min vecuronium in group B(5 cases),and with less than 1MAC of isoflurane+ 50% N,O+small dosage of fentany (< 10 μg kg-1 ) + 1~ 2 μg kg-1 min-1 vecuronium in group C (39 case ). All cases were examined with CEEG. Results CEEG was distortion in group A (75% ), group B (40N ) and group C (7. 7% ) respectively. Conclusion Low concentration of isoflurane + 50% N2O + small dosage of fenteny + relaxant can afford the suitable narcosis but not influence the formation of spike and slow wave with epilepsy to fit in with the surgery.更多还原