[Effect of remifentanil on intraoperative ECoG--a comparison with sevoflurane].
BACKGROUND
In surgeries for epilepsy, electrocorticography (ECoG) enables tailored resection of the epileptogenic brain and pharmacological stimulation should be employed in surgeries under general anesthesia. To identify the efficacy of continuous remifentanil in surgeries for epilepsy, ECoG findings with remifentanil and those with sevoflurane were compared.


METHODS
Sixteen patients with intractable epilepsy were included with institutional ethics committee approval and informed consent. General anesthesia was induced and maintained with sevoflurane, remifentanil and rocuronium. After dural opening, ECoG recordings were obtained before stimulation, with sevoflurane-stimulation (ET-sevoflurane 2.5%) and with remifentanil-stimulation (0.7 microg x kg(-1) x min(-1) for 2 min followed by 0.35 microg x kg(-1) x min(-1)).


RESULTS
In 11 of the 16 cases, activation was confirmed with remifentanil and numbers of spikes with remifentanil- and sevoflurane-stimulation were larger than those before stimulation.


CONCLUSIONS
There have been some reports on bolus remifentanil on ECoG but not on its continuous infusion. This is the first report of the effect of remifentanil on ECoG as compared to sevoflurane. In this study, continuous infusion of remifentanil showed a stimulating effect on ECoG with the same potency as sevoflurane. Remifentanil may be used as an alternative to sevoflurane.
Sato
Kiyotaka
K
Department of Neuroanesthesia, Kohnan Hospital, Sendai 982-8523.
Iwasaki
Masaki
M
Kato
Masato
M
D000280:Administration, Inhalation; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D002540:Cerebral Cortex / Q000503:physiopathology*; D004569:Electroencephalography / Q000187:drug effects*; D004827:Epilepsy / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000494:pharmacology*; D010880:Piperidines / Q000008:administration & dosage / Q000494:pharmacology*; D000077208:Remifentanil; D000077149:Sevoflurane; D013268:Stimulation, Chemical
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil