Dexmedetomidine for Electrocorticography in Patients With Lennox–Gastaut Syndrome Presenting for Epilepsy Surgery: A Case Report

Nisha, B; Thakkar, Keta; Sharma, Sushila; Hrishi, Ajay Prasad

doi:10.1213/xaa.0000000000001020

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…Propofol is a widely used analgesic drug in current diagnosis and treatment. As a short-acting intravenous anesthetic drug, pro-pofol will activate gamma-aminobutyric acid type A receptor, promote the binding of gamma-aminobutyric acid and gamma-aminobutyric acid type A receptor, promote the binding of glycine and glycine receptor, and achieve the promotion of the opening of chloride ion channels and the inhibition of synaptic transmission [11][12]. In this process, the release process of various excitatory neurotransmitters in the presynaptic membrane of the central nervous system will be regulated, the level of inhibitory transmitters in the synaptic clematis will be improved, and the synaptic transmission efficiency of excitatory and inhibitory mechanisms in the body will be inhibited [13], thus playing a calming role.…”

Section: Discussionmentioning

confidence: 99%

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

Zhang,

Zhao,

et al. 2023

IJCEMR

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Objective: To study and analyze the anesthetic effect of dexmedetomidine combined with propofol during bronchoscopy. Methods: 60 patients who received bronchoscopy in our hospital from September 2020 to October 2022 were selected and divided into study group and control group by random number table method, with 30 patients in each group. In bronchoscopy, other medical procedures except anesthesia were consistent between the two groups. The control group was given propofol anesthesia, while the study group was given dexmedetomidine combined with propofol anesthesia. The general treatment, stress indexes before and after bronchoscopy, incidence of adverse reactions and so on were evaluated and compared between the two groups. Results: There was no statistical difference in the total time spent in bronchoscopy between the two groups (P > 0.05). Anesthesia induction time and recovery time in the study group were shorter than those in the control group, and the difference was statistically significant (P < 0.05). After bronchoscopy, NE and Cor were increased in both groups, and the difference was statistically significant compared with before treatment (P < 0.05). NE and Cor levels in the study group were lower than those in the control group, and the difference was statistically significant (P < 0.05). The incidence of adverse reactions in the study group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: In bronchoscopy, dexmedetomidine combined with propofol can shorten the induction time and recovery time of anesthesia, improve the stress response of patients, and enhance the safety of examination.

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Section: Discussionmentioning

confidence: 99%

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

Zhang,

Zhao,

et al. 2023

IJCEMR

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“…20 Dexmedetomidine does not seem to have significant influence on the frequency of epileptiform discharge. 70 Hence, some authors propose utilization of dexmedetomidine in addition to other agents to aid with the depth of anesthesia without interfering with the degree of interictal spikes on ECoG. 70 Methohexital, a commonly used short-acting barbiturate, is not a widely used anesthetic agent because of its proconvulsant properties.…”

Section: Anesthesiamentioning

confidence: 99%

“…70 Hence, some authors propose utilization of dexmedetomidine in addition to other agents to aid with the depth of anesthesia without interfering with the degree of interictal spikes on ECoG. 70 Methohexital, a commonly used short-acting barbiturate, is not a widely used anesthetic agent because of its proconvulsant properties. 20,71 A dose as low as 25 mg is sufficient to elicit epileptiform discharges.…”

Section: Intraoperative Mapping Of the Epileptogenic Zonementioning

confidence: 99%

Pediatric Intraoperative Neurophysiologic Mapping and Monitoring in Brain Surgery

Alsallom,

Simon

2024

Journal of Clinical Neurophysiology

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Summary: Similar to adults, children undergoing brain surgery can significantly benefit from intraoperative neurophysiologic mapping and monitoring. Although young brains present the advantage of increased plasticity, during procedures in close proximity to eloquent regions, the risk of irreversible neurological compromise remains and can be lowered further by these techniques. More so, pathologies specific to the pediatric population, such as neurodevelopmental lesions, often result in medically refractory epilepsy. Thus, their successful surgical treatment also relies on accurate demarcation and resection of the epileptogenic zone, processes in which intraoperative electrocorticography is often employed. However, stemming from the development and maturation of the central and peripheral nervous systems as the child grows, intraoperative neurophysiologic testing in this population poses methodologic and interpretative challenges even to experienced clinical neurophysiologists. For example, it is difficult to perform awake craniotomies and language testing in the majority of pediatric patients. In addition, children may be more prone to intraoperative seizures and exhibit afterdischarges more frequently during functional mapping using electrical cortical stimulation because of high stimulation thresholds needed to depolarize immature cortex. Moreover, choice of anesthetic regimen and doses may be different in pediatric patients, as is the effect of these drugs on immature brain; these factors add additional complexity in terms of interpretation and analysis of neurophysiologic recordings. Below, we are describing the modalities commonly used during intraoperative neurophysiologic testing in pediatric brain surgery, with emphasis on age-specific clinical indications, methodology, and challenges.

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“…It either enhances or does not alter spike rate in most cases 29,30 . By its minimal effect on interictal frequency and decrease in requirement of other anesthetic agents, it offers better recovery profile in patients undergoing epilepsy surgery 31 …”

Section: Preoperative Assessmentmentioning

confidence: 99%

“…29,30 By its minimal effect on interictal frequency and decrease in requirement of other anesthetic agents, it offers better recovery profile in patients undergoing epilepsy surgery. 31 Opioids are widely used as adjuvant analgesics and sedatives. Synthetic opioids such as alfentanil, fentanyl, sufentanil, and remifentanil do not increase the risk of perioperative seizures and produce minimal changes in ECoG.…”

Section: Lesional Epilepsymentioning

confidence: 99%

Perioperative pearls on epilepsy surgery

Bindra¹

2023

International Anesthesiology Clinics

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Dexmedetomidine for Electrocorticography in Patients With Lennox–Gastaut Syndrome Presenting for Epilepsy Surgery: A Case Report

Cited by 4 publications

References 10 publications

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

Effect Analysis of Dexmedetomidine Combined With Propofol in Bronchoscopy

Pediatric Intraoperative Neurophysiologic Mapping and Monitoring in Brain Surgery

Perioperative pearls on epilepsy surgery

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