Effect of intraoperative epileptic seizure on postoperative mood and muscle strength during awake anesthesia for glioma

Abstract

Objective To investigate the effect of intraoperative epileptic seizure on postoperative mood and muscle strength during awake anesthesia (AA) for the resection of gliomas. Methods A total of 90 patients with glioma admitted to Xijing Hospital, Air Force Military Medical University of Chinese PLA from September 2020 to September 2022 were collected and divided into general anesthesia group (GA group, n = 30), awake anesthesia without intraoperative epileptic seizure group (AA group, n = 30), and awake anesthesia with intraoperative epileptic seizure group (AA + IE group, n = 30) according to the anesthesia method and the presence of intraoperative epileptic seizure. Patients' mood and muscle strength changes were assessed preoperatively and one week postoperatively by using Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and muscle strength division method. Results The differences in HAMD score (F = 9.985, P = 0.000) and muscle strength (F = 4.472, P = 0.014) at one week postoperatively were statistically significant among 3 groups. HAMD score was increased in AA group (q = 3.177, P = 0.014) and AA + IE group (q = 9.468, P = 0.000) when compared with GA group. HAMD scores was increased in AA + IE group (q = 6.290, P = 0.003) when compared with AA group. Postoperative muscle strength of AA group (q = 9.172, P = 0.006) and AA + IE group (q = 5.310, P = 0.000) was increased when compared with GA group. Muscle strength of AA + IE group was decreased compared with AA group (q = 3.862, P = 0.007). Conclusions Awake anesthesia can aggravate postoperative depression, but improve muscle strength. Intraoperative epileptic seizure can aggravate postoperative depression and decrease muscle strength. A reasonable preventive treatment plan needs to be developed in advance to reduce the incidence of intraoperative epileptic seizure.

DOI: 10.3969/j.issn.1672⁃6731.2023.05.013