• PDF / 172,357 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 91 Downloads / 170 Views

DOWNLOAD

REPORT

---

1 S

Sevoflurane/propofol Focal left hemispheric electrographic seizure and epileptiform discharges: 4 case reports

In a prospective observational study of 54 patients conducted between 21 September 2016 and 8 June 2018, four paediatric patients (3 boys and 1 girl) aged 10 weeks–13 months were described, who developed a focal left-hemispheric electrographic seizure or interictal epileptiform discharges following anaesthetic therapy with sevoflurane and/or propofol [not all doses and outcomes stated]. Case 1: A 7.9-month-old boy, who was otherwise healthy, had been undergoing chordee repair, received inhalational sevoflurane for induction of anaesthesia. During the surgery, he developed a focal left-hemispheric electrographic seizure lasting approximately 17.5 seconds approximately 9 minutes after anaesthesia induction with sevoflurane when he received an IV bolus propofol 3 mg/kg prior to laryngeal mask airway insertion. At that time, an EEG showed attenuation of all EEG activity associated with the administration of propofol. At the time of the onset of the propofol effect, an evolving electrographic seizure pattern was recorded. He had not received any other anaesthetic, and the end-tidal sevoflurane at the time of propofol bolus was 3.65%. Prior to this, his EEG had not shown any abnormalities. Case 2: A 10-week-old boy, had been undergoing liver biopsy due to cholestasis, received inhalational sevoflurane for induction of anaesthesia. He then developed interictal epileptiform discharges. He showed right frontal sharp waves maximal at electrode F4 on an EEG. Case 3: A 12-month-old boy, had been undergoing thoracoscopic resection of mediastinal mass neuroblastoma, received inhalational sevoflurane for induction of anaesthesia. He then developed interictal epileptiform discharges. An EEG showed several left frontocentral sharp waves. Case 4: A 13-month-old girl, had been undergoing thoracoscopic lower lobectomy for a congenital pulmonary airway malformation, received inhalational sevoflurane for induction of anaesthesia. She then developed interictal epileptiform discharges. She showed multifocal spikes on an EEG. 1. Chao JY, et al. Electroencephalographic findings and clinical behavior during induction of anesthesia with sevoflurane in infants. Anesthesia and Analgesia 126 (Suppl. 1): 337-338, No. 4, Apr 2018. 803519342

» Editorial comment: Details of one patient (a 7.9-month-old boy) have previously been published and processed for Adis PV [See

0114-9954/20/1833-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

1

]

Reactions 5 Dec 2020 No. 1833