Prolonged somatosensory evoked potential depression following a brief exposure to low concentrations of inhalation anaesthetic in a 3-year-old child.
A 3-year-old child was brought to the operating room for removal of a brainstem juvenile pilocytic astrocytoma. Following inhalation induction and intubation, he was maintained on 0.5% isoflurane. Somatosensory evoked potentials (SSEPs) were recorded but unobtainable initially and up to 90 min after all inhalation agents were discontinued. The operation was cancelled and the patient was transported to the paediatric intensive care unit (PICU). Subsequent PICU testing revealed a depression of amplitude with propofol and absence of potentials with 0.5% isoflurane. He returned to the operating room, was induced with propofol, and maintained with a propofol: nitrous oxide:fentanyl technique. This anaesthetic technique allowed adequate tumour resection with appropriate monitoring of SSEPs. These findings suggest that a total intravenous anaesthetic technique may be preferable for resection of spinal cord tumours where SSEPs are monitored.
Gillerman
R
R
Department of Anesthesia, Rhode Island Hospital, 593 Eddy Street, Providence RI 02903, USA.
Duncan
J
J
Bolton
J
J
D018685:Anesthetics, Inhalation / Q000009:adverse effects; D001254:Astrocytoma / Q000601:surgery; D020295:Brain Stem Neoplasms / Q000601:surgery; D002675:Child, Preschool; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects; D008297:Male; D013997:Time Factors
D018685:Anesthetics, Inhalation; D007530:Isoflurane