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Sevoflurane mask induction of anaesthesia is associated with epileptiform EEG in children

A Vakkuri1, A Yli-Hankala, M Särkelä

  • 1Department of Anaesthesia and Intensive Care, Surgical Hospital, University of Helsinki, Helsinki, Finland. anne.vakkuri@hus.fi

Acta Anaesthesiologica Scandinavica
|July 27, 2001
PubMed

Insights

Sevoflurane inhalation induction commonly causes epileptiform electroencephalogram (EEG) in children. Controlled ventilation significantly increased the incidence of these EEG abnormalities, suggesting caution in pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Neurophysiology
  • Pediatric Medicine

Background:

  • Sevoflurane inhalation induction is a common anesthetic technique in pediatric patients.
  • This method has been linked to epileptiform electroencephalograms (EEGs) in adults, particularly with controlled hyperventilation.

Purpose of the Study:

  • To assess the occurrence of epileptiform EEG discharges during sevoflurane inhalation induction in children.
  • To compare the incidence of epileptiform EEG between controlled ventilation and spontaneous breathing groups.

Main Methods:

  • Electroencephalogram (EEG) was recorded in 31 children (aged 2-12 years) during sevoflurane induction.
  • Patients were randomized to either controlled ventilation (CV) or spontaneous breathing (SB) for 5 minutes.
  • EEG recordings were analyzed for specific types of epileptiform discharges.

Main Results:

  • The overall incidence of epileptiform EEG discharges was significantly higher in the CV group (88%) compared to the SB group (20%).
  • Specific discharges like rhythmic polyspikes (PSR) and periodic epileptiform discharges (PED) were more prevalent in the CV group.
  • Epileptiform EEG activity correlated with increased heart rate and blood pressure during induction.

Conclusions:

  • Both ventilation methods induced epileptiform EEG, but controlled ventilation markedly increased the incidence in children.
  • The high rate of epileptiform discharges with controlled ventilation warrants further investigation into the safety of this induction method, especially for children with a history of epilepsy.
Abstract

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