Seizures Induced by Methohexital

Rockoff, Mark A.; Goudsouzian, Nishan G.

doi:10.1097/00000542-198104000-00015

Cited by 74 publications

(20 citation statements)

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“…There is also a small but finite risk of provoking seizure activity in patients with undiagnosed temporal lobe epilepsy. 4 The results of this study, using continuous oxygen saturation recordings to eliminate observer bias, confirms the efficacy and safety of rectal methohexitone for the induction of general anaesthesia in children between six months and six years of age. Mechanical obstruction of the airway following induction with rectal methohexitone seems to be the most likely cause for oxygen desaturation.…”

Section: Discussionsupporting

confidence: 69%

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Continuous oxygen saturation monitoring following rectal methohexitone induction in paediatric patients

1992

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Section: Discussionsupporting

confidence: 69%

“…4 The purpose of this study was to evaluate objectively the safety of this induction technique by continuous monitoring of oxygen saturation following administration of rectal methohexitone.…”

mentioning

confidence: 99%

Continuous oxygen saturation monitoring following rectal methohexitone induction in paediatric patients

1992

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“…9 In addition, seizures have been reported with rectal methohexital. 10 In contrast, the success rate of oral chloral hydrate was high throughout the study with few complications. Other studies have shown higher failure rates.…”

Section: Discussionmentioning

confidence: 86%

Trained nurses can provide safe and effective sedation for MRI in pediatric patients

Beebe

Tran

Bragg

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To determine the success rate, safety and complications using a standard protocol and trained nurses to provide sedation for MRI under the supervision of a radiologist. Materials and Methods:Nurses were trained to provide sedation via a standard protocol for pediatric patients undergoing diagnostic MRI. Oral chloral hydrate (80-100 mg·kg -1 ) was used for children less than 18 mo of age. Older children received either 1-6 mg·kg -1 pentobarbital iv, with or without 1-2 µg·kg·hr -1 fentanyl, or 25 mg·kg -1 thiopental pr. Sedation was defined as successful if it allowed completion of the MRI without image distorting patient movement. The records of 572 MRIs performed on 488 pediatric patients (mean age 5 ± 4 yr; age 2 mo-14 yr) from 1991 to July 1995 were reviewed to determine the success rate and complications using the sedation program.Results: Most, 91.8% (525/572), of the MRIs were successfully completed in 445 patients. The reasons for failure were inadequate sedation (45, 95.7%) and coughing (2, 4.2%). The failure rate was much higher before 1994 (38/272, 14%) than after (9/300, 3%; P < 0.0001). Failure was more common if rectal thiopental was used (23/172, 14%) than intravenous pentobarbital (19/256, 7.4%; P < 0.05). The failure rate was also high in patients with a history of a behavioural disorder (10/59,17%). There were no deaths or unexpected admissions as a result of the sedation program. Conclusion:A high success rate can be achieved as experience is gained using a standard protocol and trained nurses to sedate children for MRI. Méthode : Des infirmières ont été formées pour administrer la sédation selon un protocole standard à des patients pédiatriques devant subir un examen diagnostique d'IRM. L'hydrate de chloral oral (80-100 mg·kg -1 ) a servi pour les enfants de moins de 18 mois. Les plus âgés ont reçu soit 1-6 mg·kg -1 de pentobarbital iv, avec ou sans 1-2 µg·kg·hr -1 de fentanyl, soit 25 mg·kg -1 de thiopental pr. On considérait la sédation réussie quand l'IRM était achevé sans distorsion d'image par un mouvement du patient. Les enregistrements de 572 IRM réalisés chez 488 enfants (âge moyen de 5 ± 4 ans; limite d'âge de 2 mois-14 jrs) de 1991 à juillet 1995 ont été revus pour l'évaluation du taux de succès et des complications liés au programme de sédation.Résultats : La plupart des examens d 'IRM, 91,8 % (525/572), ont été réalisés avec succès chez 445 patients. Les échecs ont eu pour cause une sédation insuffisante (45, 95,7 %) et la toux (2, 4,2 %). Le taux d'échec a été beaucoup plus élevé avant 1994 (38/272, 14 %) qu'après (9/300, 3 %; P < 0,0001). L'échec était plus fréquent avec l'usage de thiopental rectal (23/172, 14 %) qu'avec le pentobarbital intraveineux (19/256, 7,4 %; P < 0,05). Le taux d'échec a été élevé également chez les patients qui présentaient des antécédents de troubles de comportement (10/59, 17 %). Aucun cas de décès ou d'admission imprévue n'a résulté de ce programme de sédation.Conclusion : Un fort taux de réussite peut être atteint à mesure que se développe l...

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“…This barbiturate is considered to be safe and effective but some EEG modifications and convulsive seizures have been reported (Gumpert et al, 1969;Rockoff et al, 1981;Metriyakool, 1981). While the pharmacokinetics of a single bolus IV injection is now well known (Hudson et al, 1983;Sear, 1983), only few data are available for conditions of continuous infusion (Breimer, 1976).…”

Section: Introductionmentioning

confidence: 99%