EEG epileptoid signs during sevoflurane induction in children: a comparative study between incremental and rapid induction

Merquiol, F.; Humblot, A.; Fares, M.; Moutard, Marie‐Laure; Murat, I.; Constant, Isabelle

doi:10.1097/00003643-200606001-00001

Cited by 5 publications

(3 citation statements)

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“…The delay to reach the target ETsevo was similar to that obtained in adults (12). The delay to obtain LOC was longer than that reported in other studies (3,16) and was similar to that reported when incremental induction was used (16). This relative slowness is because of the absence of nitrous oxide and of a lower inspiratory sevoflu- rane concentration, as the vaporizer was set at 6%, whereas in most studies it was set at 8%.…”

Section: Discussionsupporting

confidence: 83%

“…The risk factors include short delay to onset of anesthesia, high sevoflurane concentration and female gender (20). Reducing inhalation sevoflurane concentration to 6% and increasing sevoflurane concentration incrementally resulted in markedly fewer electroencephalographic epileptiform signs (16). Another way to reduce this risk could be to limit and control sevoflurane alveolar concentration as in our study, in order to prevent the risk of overdosage and to associate narcotics.…”

Section: Discussionmentioning

confidence: 76%

See 1 more Smart Citation

Target‐controlled inhalation induction with sevoflurane in children: a prospective pilot study

Fritsch

Nouette‐Gaulain

Bordes

et al. 2009

Pediatric Anesthesia

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 76%

Target‐controlled inhalation induction with sevoflurane in children: a prospective pilot study

Fritsch

Nouette‐Gaulain

Bordes

et al. 2009

Pediatric Anesthesia

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“…In children during sevoflurane induction (8% in O 2 -N 2 O, 50-50), Vakkuri (41) described epileptiform discharges in 88% of children under controlled ventilation. The speed of induction seems to play a major role: incremental induction (2-4-6% of sevoflurane) is associated with lower incidence of epileptiform discharges when compared to rapid induction (6% of sevoflurane) (42). Under steady-state conditions in adults, Jaaskelainen and Sato found seizure-like activity in all patients at >1.5 MAC sevoflurane in 100% O 2 (38,43).…”

Section: Epileptiform Activity Under Sevofluranementioning

confidence: 97%

The EEG signal: a window on the cortical brain activity

Constant

Sabourdin

2012

Pediatric Anesthesia

100

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The accurate assessment of the depth of anesthesia, allowing a more accurate adaptation of the doses of hypnotics, is an important end point for the anesthesiologist. It is a particularly crucial issue in pediatric anesthesia, in the context of the recent controversies about the potential neurological consequences of the main anesthetic drugs on the developing brain. The electroencephalogram signal reflects the electrical activity of the neurons in the cerebral cortex. It is thus the key to assessment of the level of hypnosis. Beyond visual analysis, several monitoring devices allow an automated treatment of the electroencephalographic (EEG) signal, combining time and frequency domain analysis. Each of these monitors focuses on a specific combination of characteristics of the signal and provides the clinician with useful information that remains, however, partial. For a comprehensive approach of the EEG-derived indices, the main features of the normal EEG, in adults and children, will be presented in the awake state and during sleep. Age-related modifications accompanying cerebral maturation during infancy and childhood will be detailed. Then, this review will provide an update on how anesthetic drugs, particularly hypnotics, influence the EEG signal, and how the main available monitors analyze these drug-induced modifications. The relationships between pain, memory, and the EEG will be discussed. Finally, this review will focus on some specific EEG features such as the electrical epileptoid activity observed under sevoflurane anesthesia. The EEG signal is the best window we have on cortical brain activity and provides a fair pharmacodynamic feedback of the effects of hypnotics. However, the cortex is only one of several targets of anesthesia. Hypnotics and opiates, have also subcortical primary targets, and the EEG performances in the evaluation or prediction of nociception are poor. Monitoring subcortical structures in combination with the EEG might in the future allow a better evaluation and a more precise adaptation of balanced anesthesia.

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High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia

Boonmak

Pattanittum

2016

Cochrane Database of Systematic Reviews

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EEG epileptoid signs during sevoflurane induction in children: a comparative study between incremental and rapid induction

Cited by 5 publications

References 0 publications

Target‐controlled inhalation induction with sevoflurane in children: a prospective pilot study

Target‐controlled inhalation induction with sevoflurane in children: a prospective pilot study

The EEG signal: a window on the cortical brain activity

High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia

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