RESUMO
Epilepsy surgery is performed in patients with epilepsy of focal origin and seizures which are refractory to medical treatment. Electrophysiologic mapping of the epileptic foci and other cortical areas (e.g., language, memory, sensorimotor) is frequently used to maximize the resection of the epileptogenic lesion while minimizing the neurologic deficits. For language area mapping, general endotracheal anesthesia can not be used because a patient can not vocalize. So awake craniotomy is frequently used. However, during awake craniotomy for language area mapping with local infiltration anesthesia and intravenous sedation and narcotics supplementation analgesia, respiratory arrest or depression and hypoxemia may occur. The airway securement is crucial to the patients. As an alternative to tracheal tubes, laryngeal mask airway can secure the airway and does not interference the vocalization. We could successfully performed the language area mapping in a 17-year-old male patient with laryngeal mask airway under deep intravenous anesthesia with local infiltration anesthesia of the scalp.
Assuntos
Adolescente , Humanos , Masculino , Analgesia , Anestesia , Anestesia Intravenosa , Anestesia Local , Hipóxia , Craniotomia , Depressão , Epilepsia , Máscaras Laríngeas , Memória , Entorpecentes , Manifestações Neurológicas , Couro Cabeludo , ConvulsõesRESUMO
Epilepsy surgery is performed in patients with epilepsy of focal origin and seizures which are refractory to medical treatment. Electrophysiologic mapping of the epileptic foci and other cortical areas (e.g., language, memory, sensorimotor) is frequently used to maximize the resection of the epileptogenic lesion while minimizing the neurologic deficits. For language area mapping, general endotracheal anesthesia can not be used because a patient can not vocalize. So awake craniotomy is frequently used. However, during awake craniotomy for language area mapping with local infiltration anesthesia and intravenous sedation and narcotics supplementation analgesia, respiratory arrest or depression and hypoxemia may occur. The airway securement is crucial to the patients. As an alternative to tracheal tubes, laryngeal mask airway can secure the airway and does not interference the vocalization. We could successfully performed the language area mapping in a 17-year-old male patient with laryngeal mask airway under deep intravenous anesthesia with local infiltration anesthesia of the scalp.
Assuntos
Adolescente , Humanos , Masculino , Analgesia , Anestesia , Anestesia Intravenosa , Anestesia Local , Hipóxia , Craniotomia , Depressão , Epilepsia , Máscaras Laríngeas , Memória , Entorpecentes , Manifestações Neurológicas , Couro Cabeludo , ConvulsõesRESUMO
OBJECTIVE:To study the therapeutic effect of naloxone early to administer on acute craniocerebral trauma ME_THODS:46 patients with acute craniocerebral trauma were randomly divided into two groups:Besides routine treatment,25 patients were treated with naloxone in a dose of 8mg q d ,21 patients did not treated with naloxone The GCS score,plasma ET levels,transcranial Doppler(TCD),and electroencephalogram(EEG) were measured 1 day,7 days after the administration The results were analyzed statistically RESULTS:In treatment group,GCS score was obviously improved,the level of ET in plasma was reduced;brain vasospasm incidence rate was lower and abnormal rate of EEG was lower in comparison with those in control group As a result,the detecting indices in treating group were superior to those in the control group(P