目的 观察Naroctrend(R)脑电监测在癫痫患者麻醉诱导期的使用价值,比较癫痫与非癫痫患者对丙泊酚的敏感性.方法 癫痫组(E组)为19例长期服用抗癫痫药物择期行颞叶切除术的癫痫患者,非癫痫组(NE组)为24例择期行开颅手术的非癫痫患者,麻醉诱导采用靶控输注丙泊酚,用警觉/镇静评分标准(OAA/S)评估诱导期间患者的意识变化,记录并比较意识消失、气管插管和切皮等不同时间点的Narcotrend脑电指数(NTI)、血压(BP)、心率(HR)及丙泊酚效应室靶浓度(Ce).结果 在意识消失阶段(OAA/S评分=1、2),E组患者的Ce值比NE组小(P＜0.05).随着OAA/S评分的降低,E组的Ce值上升幅度较缓,但其NTI却表现出比NE组更快的下降速度.两组患者的Ce、NTI与OAA/S评分均显著相关(P＜0.01).麻醉诱导期,随着Ce的增加,两组患者NTI、BP和HR均有显著降低(P＜0.05),但两组之间NTI未见明显差异.结论 癫痫患者在麻醉诱导阶段对丙泊酚的敏感性较高.Narcotrend(R)脑电监测系统可以用于癫痫患者诱导及维持阶段的麻醉深度监测.%Objective To investigate whether epileptic patients were more sensitive to propofol and to evaluate the efficiency of Narcotrend monitoring for such patients during the induction of anesthesia.Methods Epilepsy group included 19 patients with epilepsy subjected to the temporal lobectomy.Non - Epilepsy group included 24 patients without epilepsy underwent intracranial surgeries.All patients received target controlled infusion with propofol, and the OAA/S was used to assess consciousness change during induction.NTI, BP and HR were compared between two groups when the consciousness disappeared and during intubation and incision.Results The effect - site concentration ( Ce ) of propofol in epilepsy group when OAA/S was 1 and 2 were less than that of non - epilepsy group ( P ＜ 0.05 ).The increase of Ce in E group was slower than that of NE group with the decline of OAA/S, but the decrease of NTI in E group was faster than that of NE group.Both Ce and NTI of the two groups had significant correlations with OAA/S ( P ＜0.01 ).The values of NTI, NIBP and HR decreased gradually with the increase of Ce of propofol during induction ( P ＜0.05 ).There was no significant difference between the two groups in NTI during the periods of tracheal intubation and incision.Conclusion Epileptic patients are more sensitive to propofol than patients without epilepsy.Narcotrend monitoring can be used in epileptic patients to measure the depth of anesthesia efficiently during the induction of anesthesia.
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