Sevoflurane anaesthesia in children after induction of anaesthesia with midazolam and thiopental does not cause epileptiform EEG.
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.


CONCLUSIONS
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.
Nieminen
K
K
Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland.
Westerèn-Punnonen
S
S
Kokki
H
H
Yppärilä
H
H
Hyvärinen
A
A
Partanen
J
J
D000768:Anesthesia, General / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000139:chemically induced* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D008874:Midazolam; D000077149:Sevoflurane; D013874:Thiopental
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D013874:Thiopental; D008874:Midazolam