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J Neuroanaesth Crit Care 2018; 05(01): S1-S27
DOI: 10.1055/s-0038-1636396
Abstracts
Thieme Medical and Scientific Publishers Private Limited

Effect of Desflurane versus Propofol on ECoG Spikes in ECoG-Guided Intractable Epilepsy Surgery: Prospective Randomized Controlled Study

Authors

  • Pallavi Gaur

    1   Department of Anaesthesia, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Anita N. Shetty

    1   Department of Anaesthesia, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India

  • Nirav Kotak

    1   Department of Anaesthesia, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
Further Information

Publication History

Publication Date:
09 February 2018 (online)

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Keywords

ECoG - anesthesia - intraoperative seizures

Introduction: General anesthesia, routinely used in electrocorticography (ECoG)-guided resection of epileptic foci, requires more vigilance as intermittent period of lightened anesthesia is needed to elicit good ECoG waveforms. This is novel research to evaluate the efficacy of desflurane versus propofol in low sedating dose, having least interference with ECoG waveforms and outcome.

Methodology/Description: This is a randomized controlled study conducted with ethics committee permission and informed consent. Thirty-two patients with intractable epilepsy between 7 and 65 years and good neuropsychological assessment (IQ > 70) were included. Plane of anesthesia was lightened to facilitate ECoG recording with target MAC 0.3 to 0.4 in desflurane (D) group and propofol 25 to 75 µg/kg/min in propofol (P) group with bispectral index (BIS) of 50 to 70. ECoG recording is assessed by its onset and total duration. Withdrawal criteria were intraoperative seizures or no spikes with rescue being propofol bolus.

Results: Demographic data were comparable. ECoG onset was significantly early in P group being 3.25 minutes versus 7.67 minutes in D group (p < 0.0001). ECoG was satisfactory in all patients in P group, while two patients in D group were withdrawn due to no spike. Average total ECoG duration was higher in D group with 17.19 minutes versus 11.88 minutes in P group (p < 0.001). BIS was comparable in both groups (p > 0.05). Mean emergence time in P group was almost double that of D group (16 min). No postoperative recall was detected in any group when assessed by modified Brice questionnaire.

Conclusion: Optimal and early ECoG recording was better elicited with propofol as compared with desflurane.




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