BACKGROUND: Sevoflurane is a methyl ether anaesthetic commonly used for induction and maintenance of general anaesthesia in children. Sevoflurane is a non-irritant and acts quickly so induction is usually calm. However, inhalation induction with high concentrations of sevoflurane can cause convulsion-like movements and seizure-like changes in the electroencephalogram (EEG). Little is known about the EEG during maintenance of anaesthesia with sevoflurane, so we planned a prospective trial of sevoflurane maintenance after i.v. induction with benzodiazepine and barbiturate, which is another common induction technique in children. METHODS: EEG recordings were made before premedication with midazolam (0.1 mg kg(-1) i.v.), during induction of anaesthesia with thiopental (5 mg kg(-1)), and during maintenance with sevoflurane (2% end-tidal concentration in air/oxygen without nitrous oxide) in 30 generally healthy, 3- to 8-year-old children having adenoids removed. Noise-free EEG data of good quality were successfully recorded from all 30 children. RESULTS: Two independent neurophysiologists did not detect epileptiform discharges in any of the recordings. CONCLUSION: Premedication with midazolam, i.v. induction with thiopental and maintenance of anaesthesia with 2% sevoflurane in air does not cause epileptiform EEG patterns in children.
BACKGROUND:Sevoflurane is a methyl ether anaesthetic commonly used for induction and maintenance of general anaesthesia in children. Sevoflurane is a non-irritant and acts quickly so induction is usually calm. However, inhalation induction with high concentrations of sevoflurane can cause convulsion-like movements and seizure-like changes in the electroencephalogram (EEG). Little is known about the EEG during maintenance of anaesthesia with sevoflurane, so we planned a prospective trial of sevoflurane maintenance after i.v. induction with benzodiazepine and barbiturate, which is another common induction technique in children. METHODS: EEG recordings were made before premedication with midazolam (0.1 mg kg(-1) i.v.), during induction of anaesthesia with thiopental (5 mg kg(-1)), and during maintenance with sevoflurane (2% end-tidal concentration in air/oxygen without nitrous oxide) in 30 generally healthy, 3- to 8-year-old children having adenoids removed. Noise-free EEG data of good quality were successfully recorded from all 30 children. RESULTS: Two independent neurophysiologists did not detect epileptiform discharges in any of the recordings. CONCLUSION: Premedication with midazolam, i.v. induction with thiopental and maintenance of anaesthesia with 2% sevoflurane in air does not cause epileptiform EEG patterns in children.
Authors: Barbara Schultz; Christian Otto; Arthur Schultz; Wilhelm Alexander Osthaus; Terence Krauss; Thorben Dieck; Björn Sander; Niels Rahe-Meyer; Konstantinos Raymondos Journal: PLoS One Date: 2012-07-19 Impact factor: 3.240