Sevoflurane-induced isoelectric EEG and burst suppression: differential and antagonistic effect of added nitrous oxide.
Sevoflurane-induced isoelectric EEG and burst suppression: differential and antagonistic effect of added nitrous oxide.
复制标题
七氟烷诱导的等电脑电图和爆发抑制：添加一氧化二氮的差异和拮抗作用
DOI：
10.1111/anae.13843
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发表时间：
2017-05
期刊：
影响因子：
10.7
通讯作者：
Mei W
中科院分区：
文献类型：
--
作者：
Niu B;Xiao JY;Fang Y;Zhou BY;Li J;Cao F;Tian YK;Mei W
本研究的目的是探讨氧化亚氮对七氟醚诱导等电脑电图（ED50等电）的ED50的影响是否与对七氟醚抑制脑电图爆发（ED50burst）的ED50的影响不同。在一项前瞻性、随机、双盲、平行组、上下顺序分配研究中，77例ASA状态1和2的患者接受七氟醚诱导，气管插管后，随机分配接受七氟醚与40%空气含氧（对照组）或60%氧气混合物氧化亚氮（亚氮组）。两组的ed50等电性采用Dixon的上下法测定，起始浓度为2.5%，尾潮七氟醚步长为0.2%。当脉冲抑制率为100%时，脑电图为等电性。随后给予七氟醚的浓度由同一组中先前患者的等电脑电图的存在或不存在来确定。亚氮组ed50等电值为4.08 (95%CI, 3.95 ~ 4.38)%，显著高于对照组的3.68 (95%CI, 3.50 ~ 3.78)% （p < 0.0001）。亚氮组和对照组的ED50burst值分别为3.05 (95%CI, 2.66 ~ 3.90)%和3.02 (95%CI, 3.00 ~ 3.05)% （p = 0.52）。添加60%的氧化亚氮可提高ed50等电性，但不能提高七氟醚的ed50等电性。这两个结果都没有显示麻醉剂的加性作用，这可能是预期的，并讨论了可能的原因。
The objective of this study was to investigate whether nitrous oxide influenced the ED50 of sevoflurane for induction of isoelectric electroencephalogram (ED50isoelectric) differently from its influence on the ED50 of sevoflurane for electroencephalogram burst suppression (ED50burst). In a prospective, randomised, double‐blind, parallel group, up–down sequential allocation study, 77 ASA physical status 1 and 2 patients received sevoflurane induction and, after tracheal intubation, were randomly allocated to receive sevoflurane with either 40% oxygen in air (control group) or 60% nitrous oxide in oxygen mixture (nitrous group). The ED50isoelectric in the two groups was determined using Dixon's up and down method, starting at 2.5% with 0.2% step size of end‐tidal sevoflurane. The electroencephalogram was considered as isoelectric when a burst suppression ratio of 100% lasted > 1 min. The subsequent concentrations of sevoflurane administered were determined by the presence or absence of isoelectric electroencephalogram in the previous patient in the same group. The ED50isoelectric in the nitrous group 4.08 (95%CI, 3.95–4.38)% was significantly higher than that in the control group 3.68 (95%CI, 3.50–3.78)% (p < 0.0001). The values for ED50burst were 3.05 (95%CI, 2.66–3.90)% and 3.02 (95%CI, 3.00–3.05)% in nitrous group and control group, respectively (p = 0.52). The addition of 60% nitrous oxide increases ED50isoelectric, but not the ED50burst of sevoflurane. Neither result indicates an additive effect of anaesthetic agents, as might be expected, and possible reasons for this are discussed.