Sedation with dexmedetomidine for conducting electroencephalogram in a patient with Angelman syndrome: a case report

Fernandes, Magda Lourenço; Santos, Maria do Carmo; Gomez, Renato Santiago

doi:10.1016/j.bjane.2013.06.020

Cited by 6 publications

(8 citation statements)

References 12 publications

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“…The systematic review of the literature identified one case series of anesthetic management in English ( 14 ), one English case series of dental care which briefly discusses anesthetic management ( 15 ), a case series in German 13 and case reports in English ( 6 - 8 , 11 , 12 , 16 - 21 ), Spanish ( 22 - 24 ), and Japanese ( 25 - 30 ). Two reports ( 8 ) appear to reference the same case.…”

Section: Resultsmentioning

confidence: 99%

Anesthetic Considerations for Angelman Syndrome: Case Series and Review of the Literature

et al. 2017

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BackgroundAngelman syndrome is a rare neurodevelopmental disorder characterized by intellectual disability, severe speech impairment, ataxia, seizures, happy demeanor, distinctive craniofacial features, high vagal tone, and gamma-amino butyric acid receptor abnormalities. The aim of this report is to review our experience of patients with Angelman syndrome undergoing anesthetic management.MethodsWe retrospectively reviewed perioperative course of patients with Angelman syndrome who underwent procedures under anesthesia from 2000 to 2016.ResultsSix patients with Angelman syndrome underwent 18 procedures; 14 performed under general anesthesia, and 4 with monitored anesthetic care, many for minor procedures (e.g., dental and diagnostic). Five patients had profound developmental delay and were nonverbal and 4 of them had epilepsy. The perioperative courses were uncomplicated except a 2 year-old girl having an intraoperative bronchospasm, a 16 year-old girl requiring flumazenil administration, and 28 year-old man who was electively intubated with a videolaryngoscope because of airway management concerns. No patients were documented as having postoperative pain.ConclusionsAngelman syndrome patients often require anesthesia for relatively innocuous procedures, and their speech impairment and happy demeanor can confound postoperative pain assessment. Patients can have atypical responses to benzodiazepines. Craniofacial abnormalities can complicate airway management. Although not encountered in this series, anesthesiologists need to be aware that Angelman syndrome patients have developed malignant bradydysrhythmias while anesthetized.

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Section: Resultsmentioning

confidence: 99%

Anesthetic Considerations for Angelman Syndrome: Case Series and Review of the Literature

et al. 2017

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“…α 2 -adrenoceptors agonists have relevant physiological properties which induce sedation and analgesia, plasma catecholamine reduction, attenuation of surgery induced stress responses, and shivering prevention via the α 2 -adrenoceptors in the central nervous system [9]. Dexmedetomidine promotes sedation in a manner similar to physiological sleep (cooperative sedation) due to its regulation of wakefulness through its action on the ventrolateral preoptic nucleus (VLOP) neuronal circuity [10,11]. It is also evident that perineural dexmedetomidine when added to local T anaesthetic can prolong the duration of analgesia through blocking of the hyperpolarization-activated cation current [12].…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine with magnesium sulphate as adjuvants in caudal block to augment anaesthesia and analgesia in paediatric lower abdominal surgeries

Sayed

Kamel

Riad

et al. 2018

Egyptian Journal of Anaesthesia

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To investigate the implication of dexmedetomidine and magnesium sulphate addition to bupivacaine in caudal anesthesia in paediatric lower abdominal surgeries. Study design: Randomized controlled trial. Setting: Paediatric University Hospital. Subjects: 120 children undergoing surgeries in the lower half of the body under general anaesthesia with a supplementary caudal block using 1 ml/kg bupivacaine 0.25%. Methods: Participants were randomly allocated into four groups; group C (saline as an additive to bupivacaine), group MG (50 mg magnesium sulphate added to bupivacaine), group D (1 µg/kg dexmedetomidine added to bupivacaine), and group MGD (the same doses of both dexmedetomidine and magnesium sulphate were added to bupivacaine). Time to first analgesia request (1ry outcome), and pain assessment by The Face, Legs, Activity, Cry, Consolability (FLACC) score just after recovery, then every 30 min in the early two hours, then at the 4th, 6th, 12th,18th, and 24th hours were compared between the groups. Results: Time to first analgesia request was significantly longer in the three study groups compared to group C with p < 0.001 (median values of 5, 14.5, 13.5, and 20.47 h in groups C, D, MG, and MGD in consequence). FLACC scores were significantly higher in group C in comparison to the other study groups by the early 2nd, 4th, and 6th postoperative hours. The group MGD has significantly lowest FLACC at the 6th postoperative hour. Conclusion: The combination of dexmedetomidine and magnesium sulphate with bupivacaine caudal block can prolong the time to first analgesia request.

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“…27 One case report describes its use to achieve sedation and enable standard EEG interpretation in a 14-year-old patient with Angelman's syndrome. 28 On the other hand, one study found abrupt discontinuation of dexmedetomidine to be associated with increased risk of withdrawal seizures in infants after cardiovascular surgery. 29 When considered against standard sedative agents, dexmedetomidine provides a variety of important advantages.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine for Postoperative Sedation Following Stereotactic Lead Placement

Bui

Vega‐Talbott³

et al. 2019

Journal of Pediatric Neurology

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Dexmedetomidine has become an increasingly popular alternative to benzodiazepines and opioids as a safe agent for sedation and pain control, especially in pediatric populations. In this study, we present a case of postoperative use of dexmedetomidine in a pediatric patient, with a known history of behavioral difficulties, who underwent stereotactic lead placement for medically refractory epilepsy.

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Sedation with dexmedetomidine for conducting electroencephalogram in a patient with Angelman syndrome: a case report

Abstract: Dexmedetomidine promoted satisfactory sedation, was well tolerated and enabled the interpretation of the electroencephalogram in a patient with Angelman syndrome and seizure disorder.

Cited by 6 publications

References 12 publications

Anesthetic Considerations for Angelman Syndrome: Case Series and Review of the Literature

Anesthetic Considerations for Angelman Syndrome: Case Series and Review of the Literature

Dexmedetomidine with magnesium sulphate as adjuvants in caudal block to augment anaesthesia and analgesia in paediatric lower abdominal surgeries

Dexmedetomidine for Postoperative Sedation Following Stereotactic Lead Placement

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