title: Anesthetic management of a pediatric patient on a ketogenic diet.
abstract: There are several specific considerations regarding seizure control during the perioperative period in patients who have been placed on a ketogenic diet (KD). A KD is high in fat and low in protein and carbohydrates and has a long history of use for the treatment of intractable seizures in children. Maintaining therapeutic ketosis and modifying the acid-base balance are particularly important for preventing seizures in patients on a KD. We report changes in the biochemical parameters of a patient with double cortex syndrome who was on a KD and who had been scheduled for the treatment of dental caries under sevoflurane anesthesia and acetate Ringer administration. Inhalation induction with a high concentration of sevoflurane should be reconsidered in view of recent reports describing the epileptogenic potential of sevoflurane.
authors.affiliation: Department of Anesthesiology, Tokyo Women's Medical University, Tokyo 162-0056, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Ichikawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ozaki
authors.forename: Misako
authors.initials: M
authors.lastname: Ikeda
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Takii
authors.forename: Makoto
authors.initials: M
authors.lastname: Ozaki
mesh_terms: D000758:Anesthesia; D001786:Blood Glucose; D002648:Child; D003731:Dental Caries / Q000628:therapy; D004569:Electroencephalography; D004830:Epilepsy, Tonic-Clonic / Q000178:diet therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007657:Ketone Bodies / Q000097:blood; D008297:Male; D011229:Preanesthetic Medication; D012640:Seizures / Q000178:diet therapy*; D014883:Water-Electrolyte Imbalance / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D007657:Ketone Bodies