摘要:

The use of remifentanil for sedation during awake epilepsy surgery has been described in a case report. However, little information is available regarding the effect of remifentanil on the quality of intraoperative electrocorticography (ECoG). This study was designed to investigate the effect of sedative doses of remifentanil on ECoG interictal spike activity among patients undergoing awake anterior temporal lobectomy for refractory epilepsy. Ten adult patients were studied prospectively. After baseline EcoG recordings were obtained, remifentanil was administered as a continuous infusion at 0.1 &mgr;g/kg/min and the ECoG recorded continuously for 15 minutes. Recordings obtained before and during the administration of remifentanil were compared with respect to spike frequency and location. A trend toward a small decrease in spike frequency was observed as patients became increasingly somnolescent and background ECoG activity slowed. The difference was not statistically significant. Blood pressure and heart rate were not adversely affected by the administration of remifentanil. Respiratory rates decreased in all patients (mean decrease, 8 breaths/min) and one patient transiently developed a respiratory rate of 4 breaths per minute that elicited a decrease in the rate of remifentanil administration. Remifentanil administered at sedation doses does not adversely affect intraoperatively recorded interictal spike activity. Further investigation of the use of this drug during awake epilepsy surgery is warranted.

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Fentanyl-droperidol technique is the choice for epilepsy surgery. It requires intraoperative electrocorticography (ECoG), but a large dose of fentanyl is needed for this technique. On the other hand, sevoflurane reportedly may be beneficial for intraoperative ECoG. To reveal whether the combined technique with fentanyl and sevoflurane is beneficial for epilepsy surgery, we investigated ECoG in 10 patients with intractable temporal lobe epilepsy without sevoflurane, with 0.5 minimum alveolar concentration (MAC) sevoflurane, and with 1.5 MAC sevoflurane under fentanyl-based anesthesia. The mean number of spikes for 1 minute decreased from 38.3 to 14.1 after 1.5 MAC sevoflurane was induced, which was statistically significant (P< .05). Our results showed that balanced technique with neurolepto-analgesia (NLA) and sevoflurane is not suitable for epilepsy surgery requiring intraoperative ECoG. When epilepsy surgeries are performed under sevoflurane anesthesia, it is important to consider that sevoflurane may suppress electric activities when it is used with other anesthetic agents.

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

To clarify the epileptogenicity of sevoflurane, electrocorticograms were monitored in seven patients with unruptured cerebral aneurysm under sevoflurane anesthesia. They had no history of epilepsy or other complications. Spike activities on electrocorticography were seen in all seven patients at 3.3% end-tidal sevoflurane. These results suggest that further study is required to evaluate the suitability of sevoflurane for neurosurgical procedures.

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Oxygen-centered free radicals cause brain injury associated with trauma and stroke. These reactive oxygen species may be detoxified by endogenous antioxidants, but cell death occurs after antioxidants become depleted. General anesthetics penetrate into brain parenchyma, where they may abrogate oxidative injury to neurons by several mechanisms that prevent the initiation of free radical chain reactions or terminate the propagation of highly reactive radicals. First, general anesthetics may inhibit free radical generation because these drugs slow cerebral utilization of oxygen and glucose, inhibit oxidative metabolism in neutrophils, and prevent redox changes in hemoglobin. Second, antioxidant anesthetics, such as thiopental and propofol, directly scavenge reactive oxygen species and inhibit lipid peroxidation. Finally, anesthetics may prevent the elevation of extracellular glutamate concentration and inhibit the activation of excitatory glutamatergic receptors that augment oxidative stress after ischemia.

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0898-4921    

出版商:OVID    

年代:2002

数据来源: OVID