Asunto(s)
Analgesia Obstétrica/métodos , Analgésicos Opioides/efectos adversos , Fentanilo/efectos adversos , Dolor de Parto/tratamiento farmacológico , Intercambio Materno-Fetal , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Adulto , Analgésicos Opioides/sangre , Electroencefalografía/efectos de los fármacos , Femenino , Fentanilo/sangre , Frecuencia Cardíaca Fetal/efectos de los fármacos , Humanos , Recién Nacido , Trabajo de Parto , Proyectos Piloto , Embarazo , Adulto JovenRESUMEN
We report on the EEG monitoring of a patient who suffered an episode of postoperative ventricular fibrillation (VF) following coronary artery bypass grafting (CABG). VF initially caused a considerable suppression and slowing of the EEG. The recovery of cerebral function was evaluated by recording both EEG and auditory event related potentials (ERPs). Six hours after the episode of VF, when the patient was asleep but arousable to voice command, the N100 component of the auditory ERPs had recovered to the level measured before the operation, whereas the EEG was still very slow for that level of sedation. This may have been due to VF having less effect on the N100 component than on the background EEG. Our findings suggest that measuring evoked potentials may improve the evaluation of brain function after cardiac arrest.
Asunto(s)
Sedación Consciente , Potenciales Evocados Auditivos , Paro Cardíaco/fisiopatología , Hipnóticos y Sedantes , Complicaciones Posoperatorias/fisiopatología , Propofol , Anciano , Puente de Arteria Coronaria , Electroencefalografía/métodos , Femenino , Humanos , Monitoreo Fisiológico/métodos , Cuidados Posoperatorios/métodosRESUMEN
BACKGROUND: Sevoflurane is a methyl ether anaesthetic commonly used for induction and maintenance of general anaesthesia in children. Sevoflurane is a non-irritant and acts quickly so induction is usually calm. However, inhalation induction with high concentrations of sevoflurane can cause convulsion-like movements and seizure-like changes in the electroencephalogram (EEG). Little is known about the EEG during maintenance of anaesthesia with sevoflurane, so we planned a prospective trial of sevoflurane maintenance after i.v. induction with benzodiazepine and barbiturate, which is another common induction technique in children. METHODS: EEG recordings were made before premedication with midazolam (0.1 mg kg(-1) i.v.), during induction of anaesthesia with thiopental (5 mg kg(-1)), and during maintenance with sevoflurane (2% end-tidal concentration in air/oxygen without nitrous oxide) in 30 generally healthy, 3- to 8-year-old children having adenoids removed. Noise-free EEG data of good quality were successfully recorded from all 30 children. RESULTS: Two independent neurophysiologists did not detect epileptiform discharges in any of the recordings. CONCLUSION: Premedication with midazolam, i.v. induction with thiopental and maintenance of anaesthesia with 2% sevoflurane in air does not cause epileptiform EEG patterns in children.