EEG-controlled "overdosage" of anesthetics in a patient with a history of intra-anesthetic awareness.
In spite of the ever-growing pharmacologic arsenal available for induction and maintenance of anesthesia, to our knowledge no treatment regimen exists that will provide full protection against intraoperative awareness. To date, no single monitoring technique is able to detect awareness or predict recall. Although the frequency of these complications is rare, the occurrence of any such event can be very distressful for the patient. Based on our clinical experience with a patient with a history of recall and a marked resistance to benzodiazepines, we present electroencephalogram-based anesthetic management as a technique to address this difficult problem.
Brundidge
P K
PK
Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110.
Leavell
M E
ME
Tempelhoff
R
R
D000328:Adult; D000768:Anesthesia, General; D018681:Anesthetics, General / Q000008:administration & dosage*; D014151:Anti-Anxiety Agents; D001364:Awareness / Q000187:drug effects / Q000502:physiology*; D001569:Benzodiazepines; D017586:Diskectomy; D004361:Drug Tolerance; D004569:Electroencephalography; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007530:Isoflurane / Q000008:administration & dosage; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D011939:Mental Recall / Q000187:drug effects / Q000502:physiology; D016343:Monitoring, Intraoperative; D015742:Propofol / Q000008:administration & dosage; D013874:Thiopental / Q000008:administration & dosage
D018681:Anesthetics, General; D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D007530:Isoflurane; D013874:Thiopental; D005283:Fentanyl; D015742:Propofol