Postoperative seizures after isoflurane anesthesia.

Postoperative seizures after isoflurane anesthesia.
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DOI:
10.1213/00000539-198611000-00025
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发表时间:
1986-11
影响因子:
5.7
通讯作者:
J. L. Harrison
J. L. Harrison
中科院分区:
医学2区
文献类型:
--
作者:
J. L. Harrison

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Hymes报告了异氟烷全身麻醉期间的术中癫痫发作活动(1)。在报告的病例中,麻醉诱导后2小时,肌张力增加进展为下肢持续性肌阵挛。患者的生命体征保持不变,实验室评估(包括动脉血气分析和血清电解质和钙水平)正常。肌阵挛持续到恢复期,意识水平明显正常。济慈(2)质疑了Hymes描述的异氟烷作为患者癫痫发作病因的作用,因为患者接受了多种药物,包括地西泮、吗啡、格隆溴铵、芬太尼、d-筒箭毒碱、硫喷妥钠、琥珀胆碱、氧化亚氮和异氟烷。本报告描述了一名仅接受硫喷妥钠、一氧化二氮、氧气和异氟醚的患者的术后肌阵挛和类似痉挛的活动。
Intraoperative seizure activity during general anesthesia with isoflurane has been reported by Hymes (1). In the reported case, increased muscle tone progressed to sustained myoclonus of the lower extremities 2 hr after induction of anesthesia. The patient’s vital signs remained unchanged, and laboratory evaluation, including arterial blood gas tensions and serum levels of electrolytes and calcium, was normal. The myoclonus persisted into the recovery period in the presence of an apparently normal level of consciousness. The proposed role of isoflurane as the etiologc agent of the seizures in the patient described by Hymes has been questioned by Keats (2) on the basis that the patient had received multiple drugs including diazepam, morphine, glycopyrrolate, fentanyl, d-tubocurarine, thiopental, succinylcholine, nitrous oxide, and isoflurane. The present report describes postoperative myoclonus and seizure-like activity in a patient who received only thiopental, nitrous oxide, oxygen, and isoflurane.