Propofol sedation during awake craniotomy for seizures: electrocorticographic and epileptogenic effects

Anesthesia and Analgesia
I A HerrickJ Kirkby

Abstract

This prospective study evaluated the effects of propofol sedation on the incidence of intraoperative seizures and the adequacy of electrocorticographic (ECoG) recordings during awake craniotomy performed for the management of refractory epilepsy. Thirty patients scheduled for temporal or frontal lobectomy for epilepsy under bupivacaine scalp block were randomized to receive patient-controlled propofol sedation (PCS) combined with a basal infusion of propofol (n = 15) or neurolept analgesia using an initial bolus dose of fentanyl (0.7 microg/kg) and droperidol (0.04 mg/kg) followed by a fentanyl infusion (n = 15). Propofol administration was suspended 15 min before ECoG recording in the PCS group. The occurrence of inappropriate intraoperative seizures was noted and, based on blind review, the adequacy of ECoG recordings was compared. A higher incidence of intraoperative seizures was noted among the neurolept patients (6 vs 0, P = 0.008). Intraoperatively, ECoG recordings were adequate to proceed with resection in both groups. Evidence of low spike activity on ECoG did not correlate with the type of sedation administered. Higher frequency background ECoG activity was noted among patients who received propofol, but this did not i...Continue Reading

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Citations

May 29, 2015·Indian Journal of Anaesthesia·Navdeep SokhalP Sarat Chandra
Nov 26, 2009·The Journal of International Medical Research·Canan BalciR G Sivaci
Dec 17, 2003·Journal of Neurosurgical Anesthesiology·Patricia Fogarty MackCynthia A Lien
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Nov 11, 2008·Current Opinion in Anaesthesiology·Joshua H Atkins, Jeff E Mandel
Jul 21, 2009·European Journal of Anaesthesiology·Vincent BonhommePol Hans
Feb 2, 2010·Journal of Neurosurgical Anesthesiology·Valeria ConteNino Stocchetti
Jul 6, 2013·Journal of the Chinese Medical Association : JCMA·Wen-Kuei FangKuo-Chang Huang
Feb 24, 2006·Anesthesia and Analgesia·Andrius P Skucas, Alan A Artru
Mar 6, 2012·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Brandon Kirsch, Mark Bernstein
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Jan 5, 2002·Journal of Neurosurgical Anesthesiology·Ian A HerrickAdrian W Gelb
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Feb 24, 2006·Paediatric Anaesthesia·Lucinda L EverettJeffrey G Ojemann
Jan 5, 2002·Journal of Neurosurgical Anesthesiology·Toshiki EndoTakashi Yoshimoto

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