Intravenous methylprednisolone reduces the risk of propofol-induced adverse effects during Wada testing.
The adverse effects and risks associated with intracarotid propofol injection during Wada testing were retrospectively compared in two groups of patients with (n = 75) and without (n = 58) intravenous methylprednisolone administered before intracarotid propofol injection. The incidences of all adverse effects were decreased in the methylprednisolone group. In particular, severe adverse effects such as increased muscle tone with twitching and rhythmic movements or tonic posture, which could adversely affect Wada test results, were seen in one patient in the methylprednisolone group and seven patients in the control group, indicating 92% risk reduction. This study suggests that Wada testing using intravenous methylprednisolone administration prior to propofol injection is a safe approach to the preoperative evaluation of brain tumors, epilepsy, and arteriovenous malformations.
Mikuni
Nobuhiro
N
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Japan. mikunin@kuhp.kyoto-u.ac.jp
Yokoyama
Youhei
Y
Matsumoto
Atsuhito
A
Kikuchi
Takayuki
T
Yamada
Shigeki
S
Hashimoto
Nobuo
N
Miyamoto
Susumu
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D002339:Carotid Arteries; D002540:Cerebral Cortex / Q000187:drug effects; D016009:Chi-Square Distribution; D002648:Child; D003943:Diagnostic Techniques, Neurological / Q000009:adverse effects*; D004292:Dominance, Cerebral / Q000187:drug effects; D004409:Dyskinesia, Drug-Induced / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D009129:Muscle Tonus / Q000187:drug effects; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D011292:Premedication / Q000379:methods; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
D018686:Anesthetics, Intravenous; D018696:Neuroprotective Agents; D008775:Methylprednisolone; D015742:Propofol