ISSN 2398-2950      

Anesthesia: in epileptic patient

ffelis

Introduction

Anesthetic considerations

  • A thorough preanesthetic examination should be performed to establish the likely cause of seizures Seizures.
  • Antiepileptic therapy should not be discontinued perioperatively.
  • Epilepticogenic drugs should be avoided in the anesthetic protocol.

Preanesthetic examination

  • Differentiate seizure activity from syncopal attacks (cardiac/respiratory disease) or muscle fatigue (neuromuscular dysfunction).
  • Rule out extracranial causes of seizures (hypoglycemia Hypoglycemia, hypocalcemia Blood biochemistry: total calcium, electrolyte abnormalities, neuromuscular disease, cardiac disease, respiratory disease, hepatic/renal dysfunction,) using full hematology and biochemistry in conjunction with clinical examination.
  • Identify intracranial causes by thorough clinical examination (head trauma  Head: trauma, neoplasia Brain neoplasia, infection, idiopathic epilepsy Epilepsy: idiopathic).
  • Alkaline phosphatase levels Blood biochemistry: alkaline phosphatase will be elevated in patients receiving phenobarbitone Phenobarbital.

Preanesthetic management

  • Continue antiepileptic medications perioperatively.
  • Access to water should be available up until the time of premedication Anesthetic premedication: overview as phenobarbitone and potassium bromide Potassium bromide cause polydipsia.
  • Intravenous access should be secured.

Anesthetic management

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Anesthesia for seizure management

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Summary

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Further Reading

Publications

Refereed papers

Other sources of information

  • Garner J L, Kirby R, Rudloff E (2004) The use of acepromazine in dogs with a history of seizures. Abstract at the 10th International Veterinary Emergency and Critical Care Symposium, California.

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