title: Epileptiform activity during induction of anesthesia with sevoflurane prior to elective carotid endarterectomy.
abstract: The optimal anesthetic technique for carotid endarterectomy is still controversial. For general anesthesia, various induction agents have been used. We present two patients with asymptomatic high-grade carotid stenosis where induction with sevoflurane resulted in epileptiform discharges seen on perioperative electroencephalogram monitoring without adverse clinical sequelae. The occurrence of epileptogenic electroencephalogram during sevoflurane anesthesia has been widely described despite its popular use in pediatric anesthesia. This phenomenon, however, has not been previously described during electroencephalogram monitoring in carotid surgery. The authors suggest that induction anesthesia with sevoflurane should be avoided in this patient population especially where routine electroencephalogram monitoring is not performed.
authors: Department of Surgery, Division of Vascular Surgery, University of Cincinnati College of Medicine, Cincinnati, USA Department of Surgery, Cincinnati Veterans Affairs Medical Center, Cincinnati, USA denise.smith@uc.edu.
authors: Denise A B
authors: DA
authors: Smith
authors: Department of Surgery, Division of Vascular Surgery, University of Cincinnati College of Medicine, Cincinnati, USA Department of Surgery, Cincinnati Veterans Affairs Medical Center, Cincinnati, USA.
authors: Jonathan
authors: J
authors: Bath
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D058256:Brain Waves / Q000187:drug effects*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D017558:Elective Surgical Procedures; D004569:Electroencephalography; D016894:Endarterectomy, Carotid; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012640:Seizures / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D012720:Severity of Illness Index; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane
keywords: Carotid endarterectomy; electroencephalogram; epileptiform activity; seizure; sevoflurane