Hu Tieyi,Dan Wei,Xiong Weiming,Xie Yanfeng,Shi Quanhong,Zhan Yan,Wang Gang,Lu Bo,Tang Xiaoning.Effect of sedatives on electrocorticography during surgery for patients with secondary epilepsy caused by intracranial tumors[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(02):150-153.
Hu Tieyi,Dan Wei,Xiong Weiming,Xie Yanfeng,Shi Quanhong,Zhan Yan,Wang Gang,Lu Bo,Tang Xiaoning.Effect of sedatives on electrocorticography during surgery for patients with secondary epilepsy caused by intracranial tumors[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(02):150-153.DOI:
Effect of sedatives on electrocorticography during surgery for patients with secondary epilepsy caused by intracranial tumors
Objective To compare the effect of different sedative plans on electrocorticography (EcoG) in patients with intracranial tumors
who were undergoing surgery for epilepsy
and discuss the selection of sedative plan suitable for epilepsy surgery. Methods One hundred of patients with secondary epilepsy caused by intracranial tumors from September 2012 to January 2014 were randomly divided into 4 groups (25 patients in each group). Group A underwent anesthesia induction by intravenous injection of propofol (2 mg/kg)
sufentanil (0.5 μg/kg) and rocuronium (0.6 mg/kg)
and anesthesia maintaining by inhalation of 1% sevoflurane while controlling the concentration at 0.80±0.20 times of minimal alveolar concentration (MAC)
intravenous pumping of propofol 1.60-2.50 mg/(kg·h) and remifentanil 1 μg/(kg·h)
and intermittent application of rocuronium. Propofol was stopped about 10 min before the first ECoG monitoring (monitoring 1)
and the sevoflurane concentration was controlled at MAC0.5 during monitoring. Group B underwent the same treatment as group A except that intravenous injection of midazolam (0.1 mg/kg) was used for inducing anesthesia. Group C underwent the same treatment as group A except that propofol pumping was not stopped before monitoring. Group D underwent the same treatment as group A except that the concentration of sevoflurane was controlled at 0.5-1.0 times of MAC during monitoring. The second ECoG monitoring (monitoring 2) was performed after lesion resection
and the number of burst suppression (BS) in each group was statistically analyzed. Results The number of BS in group A was significantly less than that in group B
and the difference was statistically significant (P0.05). There was no statistically significant difference in the number of BS between group A and group C (P0.05). The number of BS in group A was significantly less than that in group D
and the difference was statistically significant (P0.05). There was one case with BS during monitoring 2 in group B. There were 13 patients undergoing intraoperative waken-up in this study
and when propofol was intravenously injected
12 patients (92.31%) showed BS. Conclusion When the patients with secondary epilepsy caused by intracranial tumors undergo surgery
the suggested sedative plan is to choose intravenous injection of propofol (2 mg/kg) for inducing anesthesia
and 1% sevoflurane inhalation and propofol pumping [1.60-2.50 mg/(kg·h)] for maintaining anesthesia. Propofol should be stopped at 10-15 min before ECoG monitoring
and the concentration of sevoflurane is lower than 0.5 times of MAC during monitoring