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目的 比较不同呼气末异氟烷浓度时癫痫及非癫痫病人脑电图及棘波的变化。方法１４例癫痫需行手术治疗及１０例非癫痫开颅手术病人，以０．７ＭＡＣ的异氟烷维持麻醉，术中置入硬膜外电极后，调整蒸发器刻度，分别控制呼气末异氟烷浓度于０．７ＭＡＣ、１．ＯＭＡＣ．１．３ＭＡＣ及１．５ＭＡＣ，并各稳定１５ｍｉｎ后，描记脑电图。结果 癫痫病人１．０ＭＡＬ异氟烷时棘波的频率与０．７ＭＡＣ时相比无明显变化，而１．３ＭＡＣ和１．５ＭＡＣ时的棘波的频率明显少于０．７ＭＡＣ（Ｐ＜０．０１）。非癫痫病人在０．７ＭＡＣ、１．０ＭＡＣ及１．３ＭＡＣ异氟烷时均无棘波出现，于 １．５ＭＡＬ时有一例出现棘波。随着呼气末异氟烷浓度的升高所有病人的α和β波逐渐减少，而δ波增多。结论 癫痫手术用异氟烷维持麻醉，术中需行皮层脑电图监测时，将异氟烷麻醉深度维持于０．７～１．０ＭＡＣ较为适宜，以保证癫痫源灶准确的定位及手术切除范围。
Objective To compare the changes of electroencephalogram (EEG) and spikes in patients with epilepsy and non-epilepsy at different expiratory isoflurane concentrations. Methods Fourteen patients with epilepsy underwent surgery and 10 patients undergoing craniotomy without epilepsy were anesthetized with 0.7MAC of isoflurane. After the epidural electrode was inserted into the epidural space, the scale of the vaporizer was adjusted to control the end-stage expiration Halothane concentration of 0.7MAC, OMAC. 1.3MAC and 1.5MAC, and the stability of 15min, EEG mapping. Results The frequency of spikes in 1.0MAL isoflurane did not change significantly in epilepsy patients compared with those in 0.7MAC, while the frequencies of spikes in 1.3MAC and 1.5MAC were significantly less than 0.7MAC (P <0.05). 01). Non-epileptic patients had no spikes at 0.7MAC, 1.0MAC and 1.3MAC isoflurane, and spikes appeared at 1.5MAL. As end-tidal isoflurane concentrations increased, all patients had a gradual decrease in alpha and beta waves and an increase in delta waves. Conclusion Epileptic surgery with isoflurane to maintain anesthesia, intraoperative need for cortical EEG monitoring, the depth of isoflurane anesthesia maintained at 0.7 ~ 1.0MAC more appropriate to ensure the accurate positioning of epileptic foci and surgical resection range.