Objective      To expl

ore the intensification of propofol on electrical activity of epileptogenic focus of the secondary epilepsy in patients with supratentorial tumor by observing the effect of intravenous injection (iv) of propofol on the wave of electrocorticography (ECoG).       Methods      Patients with supratentorial tumors complicated with seizures were enrolled as a treatment group (n=60)

and patients with deep tumors or aneurysm but no seizures were enrolled as a control group (n=40). All the patients underwent conventional inhalation anesthesia. After cerebral dura mater had been incised

the administration of propofol was stopped for 10-15 min to control minimum alveolar concentration (MAC) within 0.3-0.4 and bispectral index (BIS) within 40-60. ECoG monitoring was performed in the surgical area

and the site with prominent epileptic wave was marked. After the EEG background recovered

propofol (0.1 mg/kg) was injected. The changes of ECoG epileptic wave were quantitatively and qualitatively compared between the 2 groups in 2 min before injection of propofol (period A) and the burst of suppression (period B). After lesions had been incised

the anesthesia repeated the above processes. The treatment group was divided into a T group (epileptogenic focus in the non-functional areas) and a non-T group (epileptogenic focus in the functional areas). For the patients of the T group

the treatment was repeated until the residual epileptic waves disappeared

while for those of the non-T group

no treatment was carried out. The patients were followed up for 20-24 months to compare the incidence of early postoperative epilepsy and the rate of seizure free.       Result      ① After incision of cerebral dura mater

the quantitative analysis of spike in period A and period B: The average volatility of spike was 347±30 and 479±27 mV in period A and period B

and the growth rate of volatility was about 1.20-1.60 times. The average frequency of spike was 31±6 and 44±7 Hz in period A and period B

and the growth rate of volatility was abo

ut 1.0-2.0 times. The paired t-test analysis showed the differences in the treatment group were significant (

P

0.05)

but the differences in the control group were not. Qualitative analysis of spike in period A and period B: After lesion incision

57 of 60 spikes (95.00%) were intensified in the treatment group and 4 of 40 spikes (10.00%) were intensified in the control group

and the difference was significant between the 2 groups. ② Follow-up results: 5 of 36 patients (13.89%) in the T group and 9 of 21 patients (42.86%) in the non-T group had early postoperative seizures

but there was no significant difference between the 2 groups (Chi-square=6.01

P

0.05). 32 of 36 patients (88.89%) in the T group and 13 of 21 patients (61.90%) in non-T group had Engel Ⅰ-Ⅱ

and there was significant difference between the 2 groups (Chi-square=4.30

P

0.05).       Conclusion      There is intensification of intravenous injection of small doses of propofol on epileptogenic focus of the secondary epilepsy in patients with supratentorial tumor. It can assist positioning the epileptogenic focus

guide the treatment of epileptic foci during operation and increase the rate of seizure free.