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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。
Objective To investigate a reasonable method of anesthesia for intractable epilepsy surgery. Eighteen patients with intractable epilepsy were randomly divided into three groups: group A, 4 patients were anesthetized with 50% N 2 O + 2MAC enflurane and supplemented with high-dose fentanyl (10 ~ 15μg · kg-1) and vecuronium 1 ~ 2μg · kg-1 · min-1. In group B, 5 patients were inhaled with more than 1.5 MAC of isoflurane, the same as A group. C group 39 patients with less than 1MAC isoflurane + 50% N2O inhalation. Supplemented with a small dose of fentanyl (<10μg · kg-1), the contract. All cases were routinely monitored for cortical EEG (CEEG). Results CEEG tracings were found in 75% and 40% of group A, and in group B, CEEG tracings were only found in 7.7% of group C, respectively. 92.3% did not affect the CEEG trace. Conclusions Low concentration of isoflurane + 50% N 2 O inhalation, supplemented with small doses of fentanyl and muscle relaxant can both provide adequate depth of anesthesia without inhibiting the appearance of spike and slow waves in epileptic cortex; meeting the requirements of surgery.