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Comparing propofol versus sevoflurane anesthesia for epileptogenic focus detection during positron emission

K J Wagner1, C M Schulz, T Sprenger

  • 1Klinik für Anaesthesiologie, Technische Universität München, Klinikum rechts der Isar, München, Germany - c.m.schulz@lrz.tum.de.

Minerva Anestesiologica
|July 2, 2013
PubMed

Insights

Propofol and sevoflurane anesthesia are equally suitable for pediatric epilepsy surgery evaluation using Fluorine-18-deoxyglucose-positron emission tomography (FDG-PET) scans. Both anesthetic methods effectively detect hypometabolic lesions for surgical planning.

Area of Science:

  • Neurology
  • Radiology
  • Anesthesiology

Background:

  • Fluorine-18-deoxyglucose-positron emission tomography (FDG-PET) is crucial for localizing the epileptogenic zone in epilepsy patients.
  • Anesthesia is often necessary for pediatric patients to minimize movement artifacts during FDG-PET imaging.
  • This study evaluates the impact of propofol versus sevoflurane anesthesia on FDG-PET image quality for epilepsy surgery planning.

Purpose of the Study:

  • To compare the effectiveness of propofol and sevoflurane anesthesia in pediatric focal epilepsy patients undergoing FDG-PET scans.
  • To assess the impact of these anesthetics on image quality, hypometabolic lesion detection, and lesion demarcation.

Main Methods:

  • Pediatric patients with focal epilepsy received either propofol (N.=37) or sevoflurane (N.=43) anesthesia.
  • Two blinded investigators evaluated PET scans using a 3-point Likert scale for image quality, lesion detectability, and demarcation.
  • Statistical analysis included Mann-Whitney-U-Test and Cohen's Kappa for inter-rater reliability.

Main Results:

  • Anesthesia was uneventful with no peridiagnostic seizures in either group.
  • No statistically significant differences were found in image quality ratings or lesion detection/demarcation between propofol and sevoflurane groups.
  • Sum scores for image quality were similar (mean 5.8 ± 1.5 for propofol, 5.7 ± 1.5 for sevoflurane).

Conclusions:

  • FDG-PET is essential for identifying hypometabolic areas in epilepsy patients for surgical planning.
  • Both propofol and sevoflurane based anesthetic regimens are suitable for detecting hypometabolic cerebral lesions during FDG-PET in pediatric epilepsy patients.
  • The choice of anesthetic agent does not significantly impact the diagnostic quality of FDG-PET for epilepsy surgery evaluation.
Abstract

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