Influence of anesthetic management on quality of magnetoencephalography scan data in pediatric patients: a case series.
BACKGROUND
Magnetoencephalography (MEG) is increasingly used in the presurgical evaluation of pediatric seizure patients. Many pediatric patients require sedation or anesthesia to tolerate these exams. However, the available literature on anesthetic management in this population is very limited.


METHODS
We retrospectively reviewed the records of all patients who underwent MEG scanning at our institution with regard to the interaction of anesthetic management and quality of scan data.


RESULTS
High-dose propofol infusions (> or =200 microg.kg(-1).min(-1)) were associated with high frequency artifacts that interfered with the identification of epileptiform discharges. Lower-dose propofol infusions (< or =100 microg.kg(-1).min(-1)) did not produce artifacts but required co-administration of fentanyl to prevent patient motion. Dexmedetomidine infusions were not associated with signal artifacts and prevented patient motion very well in our initial patients and became our standard technique.


CONCLUSIONS
In our experience, dexmedetomidine infusions are preferable to propofol-based techniques for pediatric MEG scans due to the absence of adverse effect on interictal activity.
König
Matthias W
MW
Departments of Anesthesiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2001, Cincinnati, OH 45229, USA. matthias.konig@cchmc.org
Mahmoud
Mohamed A
MA
Fujiwara
Hisako
H
Hemasilpin
Nat
N
Lee
Ki H
KH
Rose
Douglas F
DF
D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000494:pharmacology; D000758:Anesthesia / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D016477:Artifacts; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D015225:Magnetoencephalography / Q000187:drug effects* / Q000379:methods; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D015742:Propofol / Q000494:pharmacology*; D012189:Retrospective Studies
D018712:Analgesics, Non-Narcotic; D018686:Anesthetics, Intravenous; D020927:Dexmedetomidine; D005283:Fentanyl; D015742:Propofol