Propofol and Seizure-Like Activity

Abstract

Objective: In this study, seizure-like activity, injection pain, and the presence of dreams after propofol injection were assessed. Material and Method: One hundred women scheduled for obstetric and gynecologic procedures were evaluated. Patients were anesthetized with 1 mg/kg propofol. Seizure-like activity was described as "only left arm. " "started from left arm and involved whole body, " or "face only, " etc. The intensity of seizure-like activity (a brief and involuntary twitching of a muscle or a group of muscles) (SLA) was graded as 0=no SLA, 1=mild SLA -Local Group (only mild fasciculation involving face and/or distal upper and/or lower extremity, focal, or involving a part of the body) and 2=severe SLA -Generalized Group (marked movements involving limbs or trunk, generalized to the whole body). Operation time, additional doses of anesthetic given, time to eye-opening, the presence of dreams, injection-induced pain, and if present, seizure-like activity descriptions were analyzed. Statistical analysis: Baseline characteristics were described with mean, standard deviation, rate, and frequency. The distribution of variables was controlled with Kolmogorov Smirnov test. Quantitative data were compared with ANOVA (Tukey), independent sample t test and Mann Whitney U test. Qualitative data were analyzed using Chi-square test and Fisher test. Statistical analysis was performed using SPSS 21.0 software. A value of p<0.05 was considered significant. Results: The patients in the generalized seizure-like activity group were statistically significantly younger than those in the group with no seizures. Intrinsically, the additional dose in the generalized group was lower than in the group with no seizures and the localized seizure group. In the localized seizure group, there was statistically significant lower injection-induced pain compared to the no-seizure group. Conclusion: Seizure-like activity could be related with the patients' age. Keywords: Seizure-Like Activity, propofol, seizures, GABA, injection induced pain ÖZ Propofol ve epileptiform aktiviteAmaç: Bu çalışmada propofol enjeksiyonunun epileptiform aktivite, enjeksiyon ağrısı, işlem sırasında rüya görmeyle olan ilişkisi incelendi. Gereç ve Yöntem: Obstetrik ve jinekolojik nedenlerle opere olan 100 hasta çalışmaya alındı. Hastalar1 mg/ kg propofol ile uyutuldu. Epileptiform aktivite olup olmadığı, olduğunda, örneğin tek kolda ya da yüzde lokalize olduğu veya tüm vücuda yayıldığı gibi gözlemler not edildi. Bu istemsiz hareketler 0=Yok, 1=Lokalize, 2=Generalize olarak sınıflandırıldı.Operasyon süresi, ilave doz ilaç yapılıp yapılmadığı, göz açma süresi, hastanın işlem sırasında rüya görüp görmediğini hatırlaması, enjeksiyon ağrısı olup olmadığı kaydedildi. İstatistik:Temel değerlendirmede ortalama ve standart sapma kullanıldı.Değişkenlerin dağılımında Kolmogorov Smirnov testi, kantitatif değerlendirmelerde ANOVA (Tukey), independent t test ve Mann Whitney U, kalitatif değerlendirmelerde Ki-kare ve Fisher testi kullanıldı. Bulgular: Generalize epilep...