Epilepside Perioperatif Yönetim ve Anestezi

Murat Türkeün Ilgınel; Demet Laflı Tunay; Yasemin Güneş

doi:10.17827/aktd.330964

Review

Epilepside Perioperatif Yönetim ve Anestezi

Year 2018, Volume: 27 Issue: 1, 39 - 69, 31.03.2018

Murat Türkeün Ilgınel Demet Laflı Tunay Yasemin Güneş

https://doi.org/10.17827/aktd.330964

Abstract

Epilepsi paroksismal, tekrarlayıcı nöbetlerle seyreden klinik bir hastalık olup popülasyonun önemli oranını etkiler; böylelikle epilepsili hastalar anestezi uygulamalarının önemli bir bileşenini oluşturmaktadır. Antiepileptik ajanların anestezi üzerine etkisi olabilecek birçok fizyolojik ve farmakolojik etkisi mevcuttur; bunun yanı sıra anestezik ajanların kendilerinin de nöbet aktivitesini modüle etme veya güçlendirme kapasitesi vardır. Bu derlemede epilepsili olguların perioperatif yönetiminde izlenecek planı; ayrıca güncel epilepsi cerrahisine özgü anestezik yaklaşımı ortaya koymayı amaçladık.

Keywords

Anestezi, Epilepsi, ilaç etkileşimi

References

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2) Goldensohn ES – Historical Perspective, em: Engel Jr J, Pedley TA . Epilepsy: a Comprehensive Textbook, Philadelphia, Lippincott-Raven, 1997;15-16.
3) A. Perks S. Cheema.R. Mohanraj. Anaesthesia and epilepsy. Br J Anaesth. 2012; 108 (4): 562-71
4) Ren WHP. Anesthetic management of epileptic pediatric patients. Int Anesthesiol Clin. 2009; 47:101-116.
5) Chin RFM, Neville BGR, Scott RC. A systematic review of the epidemiology of status epilepticus. Eur J Neurol. 2004;11(12):800-810.
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9) Fisher RS, Cross JH, D’Souza C, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017;58(4):531-542.
10) American Epilepsy Society (AES) 2016 Annual Meeting. “Symposium: The New Definition and Classification of Epilepsy.” Presented December 2, 2016.
11) Shetty A, Pardeshi S, Shah VM, Kulkarni A. Anesthesia considerations in epilepsy surgery. International Journal of Surgery. 2015; 1-6
12) Kofke WA. Anesthetic management of the patient with epilepsy or prior seizures. Curr Opin Anaesthesiol. 2010;23(3):391-399.
13) Bloor M, Nandi R, Thomas M. Antiepileptic drugs and anesthesia. Paediatr Anaesth. 2017;27(3):248-250.
14) Rizzutti S, Nishiyama AN, Muszkat M et al. – Epilepsias. Tratamentos alternativos. Rev Neurociencias, 1999;7:32-38.
15) Valencia I, Pfeifer H, Thiele EA. General anesthesia and the ketogenic diet: Clinical experience in nine patients. Epilepsia. 2002;43(5):525-529.
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19) Wang B, Bai Q, Jiao X, Wang E, White PF. Effect of sedative and hypnotic doses of propofol on the EEG activity of patients with and without a history of seizure disorders. J Neurosurg Anesthesiol. 1997;9:335-340.
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21) Miyazaki Y, Adachi T, Kurata J, Utsumi J, Shichino T, Segawa H. Dexmedetomidine reduces seizure threshold during enflurane anaesthesia in cats. Br J Anaesth. 1999;82(6):935-937.
22) Sturaitis MK, Ford EW, Palac SM,. Smith MC, Tuman KJ: Effect of dexmedetomidine on operative conditions and electrocorticographic responses during asleep craniotomy for seizure focus resection. ASA Meeting Abstract number A- 290, 2003
23) Ahmed SU, Vallejo R, Hord ED. Seizures after a Bier block with clonidine and lidocaine. Anesth Analg. 2004;99(2):593-594.
24) Wass CT, Grady RE, Fessler AJ, et al. The Effects of Remifentanil on Epileptiform Discharges during Intraoperative Electrocorticography in Patients Undergoing Epilepsy Surgery. Epilepsia. 2001;42(10):1340-1344.
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27) Tommasino C, Maekawa T, Shapiro HM, Keifer-Goodman J, Kohlenberger RW. Fentanyl-induced seizures activate subcortical brain metabolism. Anesthesiology. 1984;60(4):283-290.
28) Kofke WA, Garman RH, Tom WC, Rose ME, Hawkins RA. Alfentanil-induced hypermetabolism, seizure, and histopathology in rat brain. Anesth Analg. 1992;75(6):953-964.
29) Siggins GR, Henriksen SJ, Chavkin C, Gruol D. Opioid peptides and epileptogenesis in the limbic system: cellular mechanisms. Adv Neurol. 1986;44:501-512.
30) Zieglgänsberger W, French ED, Siggins GR, Bloom FE. Opioid peptides may excite hippocampal pyramidal neurons by inhibiting adjacent inhibitory interneurons. Science. 1979;205(4404):415-417.
31) Hoffman WE, Cunningham F, James MK, Baughman VL, Albrecht RF. Effects of remifentanil, a new short-acting opioid, on cerebral blood flow, brain electrical activity, and intracranial pressure in dogs anesthetized with isoflurane and nitrous oxide. Anesthesiology. 1993;79(1):107-113
32) Haber GW, Litman RS. Generalized Tonic-Clonic Activity After Remifentanil Administration. Anesth Analg. 2001;93(6):1532-1533.
33) Herrick IA, Craen RA, Blume WT, Novick T, Gelb AW. Sedative doses of remifentanil have minimal effect on ECoG spike activity during awake epilepsy surgery. J Neurosurg Anesthesiol. 2002;14(1):55-58.
34) Constant I, Seeman R, Murat I. Sevoflurane and epileptiform EEG changes. Paediatr Anaesth. 2005;15(4):266-274.
35) Akeson J, Didriksson I. Convulsions on anaesthetic induction with sevoflurane in young children. Acta Anaesthesiol Scand 2004;48:405-407.
36) Scheller MS, Tateishi A, Drummond JC, Zornow MH. The effects of sevoflurane on cerebral blood flow, cerebral metabolic rate for oxygen, intracranial pressure, and the electroencephalogram are similar to those of isoflurane in the rabbit. Anesthesiology. 1988;68(4):548-551.
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38) Kaisti KK, Jaaskelainen SK, Rinne JO, Metsahonkala L, Scheinin H: Epileptiform discharges during 2 MAC sevoflurane anesthesia in two healthy volunteers. Anesthesiology. 1999;91:1952-1955
39) Iijima T, Nakamura Z, Iwao Y, Sankawa H. The Epileptogenic Properties of the Volatile Anesthetics Sevoflurane and Isoflurane in Patients with Epilepsy. Anesth Analg. 2000;91(4):989-995.
40) Mirsattari SM, Sharpe MD, Young GB. Treatment of refractory status epilepticus with inhalational anesthetic agents isoflurane and desflurane. Arch Neurol. 2004;61(8):1254-1259.
41) Sharpe MD, Young GB, Mirsattari S, Harris C. Prolonged desflurane administration for refractory status epilepticus. Anesthesiology 2002; 97:261–264.
42) Hoffman WE, Edelman G. Comparison of isoflurane and desflurane anesthetic depth using burst suppression of the electroencephalogram in neurosurgical patients. Anesth Analg. 1995;81(4):811-816.
43) Spacek A, Nickl S, Neiger FX, et al. Augmentation of the rocuronium-induced neuromuscular block by the acutely administered phenytoin. Anesthesiology. 1999;90(6):1551-1555.
44) Melton AT, Antognini JE, Gronert GA. Prolonged duration of succinylcholine in patients receiving anticonvulsants: evidence for mild up-regulation of acetylcholine receptors? Can J Anaesth. 1993;40(10):939-942.
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46) Pedroviejo V, Ayuso M, Jiménez A. Tratamiento anestésico del paciente adulto epiléptico no neuroquirúrgico. Rev Esp Anestesiol Reanim. 2009;56(7):425-435.
47) Kopp SL, Wynd KP, Horlocker TT, Hebl JR, Wilson JL. Regional blockade in patients with a history of a seizure disorder. Anesth Analg. 2009;109(1):272-278.
48) Walton NY. Systemic effects of generalized convulsive status epilepticus. Epilepsia. 1993;34(S1):54-58.
49) Holtkamp M. The anaesthetic and intensive care of status epilepticus. Curr Opin Neurol. 2007;20(2):188-193.
50) Parviainen I, Uusaro A, Kalviainen R, Kaukanen E, Mervaala E, Ruokonen E. High-dose thiopental in the treatment of refractory status epilepticus in intensive care unit. Neurology. 2002;59(8):1249-1251.
51) Claassen J, Hirsch LJ, Emerson RG, Mayer SA. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: A systematic review. Epilepsia. 2002;43(2):146-153.
52) Herrick IA, Craen RA, Gelb AW, McLachlan RS, Girvin JP, Parrent AG, et al. Propofol sedation during awake craniotomy for seizures: electrocorticographic and epileptogenic effects. Anesth Analg. 1997;84:1280-1284.
53) Erickson KM, Cole DJ. Anesthetic Considerations for Awake Craniotomy for Epilepsy and Functional Neurosurgery. Anesthesiol Clin. 2012;30(2):241-268.
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Perioperative Management and Anesthesia in Epilepsy

Year 2018, Volume: 27 Issue: 1, 39 - 69, 31.03.2018

Murat Türkeün Ilgınel Demet Laflı Tunay Yasemin Güneş

https://doi.org/10.17827/aktd.330964

Abstract

Epilepsy, which is a paroxysmal clinical disease with recurring seizures, influences a significant proportion of the population. Thus epileptic patients constitute an important component of anesthesia practice. Antiepileptic agents have many physiological and pharmacological effects which may have an effect on anesthesia; and also the anesthetic agents themselves have the capacity to modulate or potentiate seizure activity. In this review, we aimed to reveal the plan of perioperative management of epileptic patients; and also the anesthetic approach specific to current epilepsy surgery.

Keywords

Anesthesia, drug interactions, epilepsy

References

1) Maranhão MVM, Gomes EA, de Carvalho PE. Epilepsy and Anesthesia. Rev Bras Anestesiol 2011;61(2): 232-254.
2) Goldensohn ES – Historical Perspective, em: Engel Jr J, Pedley TA . Epilepsy: a Comprehensive Textbook, Philadelphia, Lippincott-Raven, 1997;15-16.
3) A. Perks S. Cheema.R. Mohanraj. Anaesthesia and epilepsy. Br J Anaesth. 2012; 108 (4): 562-71
4) Ren WHP. Anesthetic management of epileptic pediatric patients. Int Anesthesiol Clin. 2009; 47:101-116.
5) Chin RFM, Neville BGR, Scott RC. A systematic review of the epidemiology of status epilepticus. Eur J Neurol. 2004;11(12):800-810.
6) Commission on Classification and Terminology of the International League against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989; 30:389-399.
7) Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology. Epilepsia 2010;51:676-85.
8) Aminof MJ – Nervous System Disorders, em: McPhee SJ, Papadakis MA – Current Medical Diagnosis and Treatment, 49th Ed, New York, McGraw Hill Lange, 2009;878-889
9) Fisher RS, Cross JH, D’Souza C, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017;58(4):531-542.
10) American Epilepsy Society (AES) 2016 Annual Meeting. “Symposium: The New Definition and Classification of Epilepsy.” Presented December 2, 2016.
11) Shetty A, Pardeshi S, Shah VM, Kulkarni A. Anesthesia considerations in epilepsy surgery. International Journal of Surgery. 2015; 1-6
12) Kofke WA. Anesthetic management of the patient with epilepsy or prior seizures. Curr Opin Anaesthesiol. 2010;23(3):391-399.
13) Bloor M, Nandi R, Thomas M. Antiepileptic drugs and anesthesia. Paediatr Anaesth. 2017;27(3):248-250.
14) Rizzutti S, Nishiyama AN, Muszkat M et al. – Epilepsias. Tratamentos alternativos. Rev Neurociencias, 1999;7:32-38.
15) Valencia I, Pfeifer H, Thiele EA. General anesthesia and the ketogenic diet: Clinical experience in nine patients. Epilepsia. 2002;43(5):525-529.
16) Benish SM, Cascino GD, Warner ME, Worrell GA, Wass CT. Effect of general anesthesia in patients with epilepsy: a population-based study. Epilepsy Behav. 2010;17(1):87-89.
17) Modica PA, Tempelhoff R, White PF. Pro- and anticonvulsant effects of anesthetics (Part I). Anesth Analg 1990;70:303–315.
18) Hickey R. Effects of anesthesia on cerebral and spinal cord physiology . In: Newfield P, Cottrell JE. Handbook of Neuroanesthesia. Lippincott Williams and Wilkins.
19) Wang B, Bai Q, Jiao X, Wang E, White PF. Effect of sedative and hypnotic doses of propofol on the EEG activity of patients with and without a history of seizure disorders. J Neurosurg Anesthesiol. 1997;9:335-340.
20) Parviainen I, Uusaro A, Kälviäinen R, Mervaala E, Ruokonen E. Propofol in the treatment of refractory status epilepticus. Intensive Care Med. 2006;32(7):1075-1079.
21) Miyazaki Y, Adachi T, Kurata J, Utsumi J, Shichino T, Segawa H. Dexmedetomidine reduces seizure threshold during enflurane anaesthesia in cats. Br J Anaesth. 1999;82(6):935-937.
22) Sturaitis MK, Ford EW, Palac SM,. Smith MC, Tuman KJ: Effect of dexmedetomidine on operative conditions and electrocorticographic responses during asleep craniotomy for seizure focus resection. ASA Meeting Abstract number A- 290, 2003
23) Ahmed SU, Vallejo R, Hord ED. Seizures after a Bier block with clonidine and lidocaine. Anesth Analg. 2004;99(2):593-594.
24) Wass CT, Grady RE, Fessler AJ, et al. The Effects of Remifentanil on Epileptiform Discharges during Intraoperative Electrocorticography in Patients Undergoing Epilepsy Surgery. Epilepsia. 2001;42(10):1340-1344.
25) Cascino GD, So EL, Sharbrough FW, et al. Alfentanil-induced epileptiform activity in patients with partial epilepsy. J Clin Neurophysiol Off Publ Am Electroencephalogr Soc. 1993;10(4):520-525.
26) Young ML, Smith DS, Greenberg J, Reivich M, Harp JR. Effects of sufentanil on regional cerebral glucose utilization in rats. Anesthesiology. 1984;61(5):564-568.
27) Tommasino C, Maekawa T, Shapiro HM, Keifer-Goodman J, Kohlenberger RW. Fentanyl-induced seizures activate subcortical brain metabolism. Anesthesiology. 1984;60(4):283-290.
28) Kofke WA, Garman RH, Tom WC, Rose ME, Hawkins RA. Alfentanil-induced hypermetabolism, seizure, and histopathology in rat brain. Anesth Analg. 1992;75(6):953-964.
29) Siggins GR, Henriksen SJ, Chavkin C, Gruol D. Opioid peptides and epileptogenesis in the limbic system: cellular mechanisms. Adv Neurol. 1986;44:501-512.
30) Zieglgänsberger W, French ED, Siggins GR, Bloom FE. Opioid peptides may excite hippocampal pyramidal neurons by inhibiting adjacent inhibitory interneurons. Science. 1979;205(4404):415-417.
31) Hoffman WE, Cunningham F, James MK, Baughman VL, Albrecht RF. Effects of remifentanil, a new short-acting opioid, on cerebral blood flow, brain electrical activity, and intracranial pressure in dogs anesthetized with isoflurane and nitrous oxide. Anesthesiology. 1993;79(1):107-113
32) Haber GW, Litman RS. Generalized Tonic-Clonic Activity After Remifentanil Administration. Anesth Analg. 2001;93(6):1532-1533.
33) Herrick IA, Craen RA, Blume WT, Novick T, Gelb AW. Sedative doses of remifentanil have minimal effect on ECoG spike activity during awake epilepsy surgery. J Neurosurg Anesthesiol. 2002;14(1):55-58.
34) Constant I, Seeman R, Murat I. Sevoflurane and epileptiform EEG changes. Paediatr Anaesth. 2005;15(4):266-274.
35) Akeson J, Didriksson I. Convulsions on anaesthetic induction with sevoflurane in young children. Acta Anaesthesiol Scand 2004;48:405-407.
36) Scheller MS, Tateishi A, Drummond JC, Zornow MH. The effects of sevoflurane on cerebral blood flow, cerebral metabolic rate for oxygen, intracranial pressure, and the electroencephalogram are similar to those of isoflurane in the rabbit. Anesthesiology. 1988;68(4):548-551.
37) Vakkuri A, Yli-Hankala A, Särkelä M, et al. Sevoflurane mask induction of anaesthesia is associated with epileptiform EEG in children. Acta Anaesthesiol Scand. 2001;45(7):805-811.
38) Kaisti KK, Jaaskelainen SK, Rinne JO, Metsahonkala L, Scheinin H: Epileptiform discharges during 2 MAC sevoflurane anesthesia in two healthy volunteers. Anesthesiology. 1999;91:1952-1955
39) Iijima T, Nakamura Z, Iwao Y, Sankawa H. The Epileptogenic Properties of the Volatile Anesthetics Sevoflurane and Isoflurane in Patients with Epilepsy. Anesth Analg. 2000;91(4):989-995.
40) Mirsattari SM, Sharpe MD, Young GB. Treatment of refractory status epilepticus with inhalational anesthetic agents isoflurane and desflurane. Arch Neurol. 2004;61(8):1254-1259.
41) Sharpe MD, Young GB, Mirsattari S, Harris C. Prolonged desflurane administration for refractory status epilepticus. Anesthesiology 2002; 97:261–264.
42) Hoffman WE, Edelman G. Comparison of isoflurane and desflurane anesthetic depth using burst suppression of the electroencephalogram in neurosurgical patients. Anesth Analg. 1995;81(4):811-816.
43) Spacek A, Nickl S, Neiger FX, et al. Augmentation of the rocuronium-induced neuromuscular block by the acutely administered phenytoin. Anesthesiology. 1999;90(6):1551-1555.
44) Melton AT, Antognini JE, Gronert GA. Prolonged duration of succinylcholine in patients receiving anticonvulsants: evidence for mild up-regulation of acetylcholine receptors? Can J Anaesth. 1993;40(10):939-942.
45) Bhagat H, Dash HH. Anesthesiologist’s role in the management of an epileptic patient. Indian J Anaesth, Indian J. Anaesth. 2006;50(1):20-26
46) Pedroviejo V, Ayuso M, Jiménez A. Tratamiento anestésico del paciente adulto epiléptico no neuroquirúrgico. Rev Esp Anestesiol Reanim. 2009;56(7):425-435.
47) Kopp SL, Wynd KP, Horlocker TT, Hebl JR, Wilson JL. Regional blockade in patients with a history of a seizure disorder. Anesth Analg. 2009;109(1):272-278.
48) Walton NY. Systemic effects of generalized convulsive status epilepticus. Epilepsia. 1993;34(S1):54-58.
49) Holtkamp M. The anaesthetic and intensive care of status epilepticus. Curr Opin Neurol. 2007;20(2):188-193.
50) Parviainen I, Uusaro A, Kalviainen R, Kaukanen E, Mervaala E, Ruokonen E. High-dose thiopental in the treatment of refractory status epilepticus in intensive care unit. Neurology. 2002;59(8):1249-1251.
51) Claassen J, Hirsch LJ, Emerson RG, Mayer SA. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: A systematic review. Epilepsia. 2002;43(2):146-153.
52) Herrick IA, Craen RA, Gelb AW, McLachlan RS, Girvin JP, Parrent AG, et al. Propofol sedation during awake craniotomy for seizures: electrocorticographic and epileptogenic effects. Anesth Analg. 1997;84:1280-1284.
53) Erickson KM, Cole DJ. Anesthetic Considerations for Awake Craniotomy for Epilepsy and Functional Neurosurgery. Anesthesiol Clin. 2012;30(2):241-268.
54) Manninen PH, See J.J., Epilepsy, epilepsy surgery, awake craniotomy for tumor surgery, and intraoperative magnetic resonance imaging, in: P. Newfield, J.E. Cottrell (Eds.), Handbook of Neuroanesthesia, fourth ed., Lippincott Williams & Wilkins, 2007, pp. 198-215.
55) Huncke K, Van De Wiele B, Fried I, Rubinstein EH. The asleep-awake-asleep anesthetic technique for intraoperative language mapping. Neurosurgery. 1998;42(6):1312-1317.
56) Gadhinglajkar S, Sreedhar R, Abraham M. Anesthesia management of awake craniotomy performed under asleep-awake-asleep technique using laryngeal mask airway: report of two cases. Neurol India. 2008;56(1):65-67.
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Details

Primary Language	Turkish
Subjects	Health Care Administration
Journal Section	Review
Authors	Murat Türkeün Ilgınel Demet Laflı Tunay Yasemin Güneş
Publication Date	March 31, 2018
Acceptance Date	September 14, 2017
Published in Issue	Year 2018 Volume: 27 Issue: 1

Cite

AMA	Ilgınel MT, Laflı Tunay D, Güneş Y. Epilepside Perioperatif Yönetim ve Anestezi. aktd. March 2018;27(1):39-69. doi:10.17827/aktd.330964

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