Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series.
Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series.
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与硬膜下网格相比，立体定向脑电图与减少疼痛和阿片类药物的使用有关：案例系列。
DOI：
10.1093/ons/opab040
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Rolston,JohnD
中科院分区：
文献类型：
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作者：
Scoville,JonathanP;Joyce,Evan;Hunsaker,Joshua;Reese,Jared;Wilde,Herschel;Arain,Amir;Bollo,RobertL;Rolston,JohnD
背景微创手术 (MIS) 已被证明可以减少住院时间和阿片类药物的使用。目的确定与开颅手术进行脑电图网格放置 (ECoG) 相比，通过 MIS 立体定向脑电图 (SEEG) 电极进行癫痫标测的手术是否会减少阿片类药物的总体使用。方法通过 2015 年的回顾性图表审查来确定接受过癫痫标测手术（SEEG 或 ECoG）的患者到 2018 年。住院期间被分为特定的时间段，以区分术后立即、整个住院期间和出院时阿片类药物的使用情况。通过将所有类型的阿片类药物转换为其吗啡当量（ME）来计算每个时期消耗的阿片类药物总量。还使用临床联合疼痛评估（CAPA）量表的修改版来收集疼痛评分。使用适当的统计检验对 2 个手术组进行比较。 结果 该研究确定了 43 名符合纳入标准的患者：36 名接受了 SEEG 放置，17 名接受了开颅网格放置。 ECoG 组和 SEEG 安置组之间每次住院期间阿片类药物消耗量中位数存在统计学显着差异，分别为 307.8 ME 和 71.5 ME（P=.0011）。两组之间的 CAPA 量表也存在显着差异 (P=.0117)。 结论 与接受更具侵入性的 ECoG 手术的患者相比，通过 SEEG 进行 MIS 癫痫绘图的患者中阿片类药物的使用显着较低。作为减少阿片类药物总体负担的努力的一部分，患者和外科医生在决定手术方法时应考虑这些结果。
BACKGROUNDMinimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use.OBJECTIVETo identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG).METHODSPatients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests.RESULTSThe study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P=. 0011). There was also a significant difference in CAPA scales between the 2 groups (P=. 0117).CONCLUSIONOpioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.