title: Propofol as a substitute for amobarbital in Wada testing.
abstract: We describe a patient with equivocal findings on functional MRI (fMRI), who underwent a propofol Wada test, review the literature on this topic and suggest a protocol for the use of propofol for a Wada test. Although fMRI techniques can usually accurately lateralize language, the Wada test remains the gold standard for preoperative lateralization and is occasionally still required if there are non-diagnostic findings on fMRI. Amobarbital, the agent of choice for the Wada test, has become increasingly difficult to obtain and requires regulatory approval, which may delay definitive management and have an impact on patient outcomes. Propofol has been suggested as an alternative to amobarbital, and while there is some published data on this, there is no reported Australian experience to date.
authors.affiliation: Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Neurological Intervention and Imaging Service of Western Australia, Royal Perth Hospital, Perth, WA, Australia. Electronic address: albert.h.chiu@gmail.com.
authors.forename: Albert Ho Yuen
authors.initials: AH
authors.lastname: Chiu
authors.affiliation: Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Neurological Intervention and Imaging Service of Western Australia, Royal Perth Hospital, Perth, WA, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Bynevelt
authors.affiliation: Department of Neurology, Royal Perth Hospital, Perth, WA, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lawn
authors.affiliation: Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Lee
authors.affiliation: Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Neurological Intervention and Imaging Service of Western Australia, Royal Perth Hospital, Perth, WA, Australia.
authors.forename: Tejinder Pal
authors.initials: TP
authors.lastname: Singh
mesh_terms: D000654:Amobarbital / Q000627:therapeutic use; D001315:Australia; D001932:Brain Neoplasms / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D007807:Language Tests; D008279:Magnetic Resonance Imaging; D038361:Neuronavigation / Q000379:methods; D015742:Propofol / Q000627:therapeutic use*; D014851:Wakefulness; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D000654:Amobarbital; D015742:Propofol
keywords: Amobarbital; Interventional neuroradiology; Neoplasm; Propofol; Seizures; Sodium amytal; Wada