HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Propofol and barbiturates for the anesthesia of refractory convulsive status epilepticus: pros and cons.

AbstractOBJECTIVE:
To discuss mainly the use of propofol and barbiturates in the anesthesia of refractory status epilepticus (RSE).
METHODS:
Review of literature.
RESULTS:
There are no prospective, randomized works comparing the effects of anesthetics in the treatment of RSE. Recently, the use of propofol has increased in the treatment of RSE. Propofol terminates both clinical and electric seizures quickly, but the maintenance of burst-suppression EEG pattern requires repetitive titration of doses. Relapses of seizures have occurred in 19-33% of patients, especially when tapering of dose. The advantages of barbiturates are lower frequency of short-term treatment failures, breakthrough seizures and changes to a different anesthetic agent. On the other hand, prolonged recovery leads to prolonged duration of mechanical ventilation, intensive care and hospital stay.
DISCUSSION:
The use of propofol, barbiturates or midazolam in the anesthesia of RSE can be justified. When using propofol, the duration of high doses should be limited to 48 hours and the risk of propofol infusion syndrome should be kept in mind. High doses of barbiturates terminate effectively seizures but recovery from anesthesia prolongs ventilator treatment and intensive care.
AuthorsIlkka Parviainen, Reetta Kälviäinen, Esko Ruokonen
JournalNeurological research (Neurol Res) Vol. 29 Issue 7 Pg. 667-71 (Oct 2007) ISSN: 0161-6412 [Print] England
PMID18173905 (Publication Type: Journal Article, Review)
Chemical References
  • Anesthetics, Intravenous
  • Anticonvulsants
  • Barbiturates
  • Midazolam
  • Propofol
Topics
  • Anesthetics, Intravenous (administration & dosage, adverse effects)
  • Anticonvulsants (administration & dosage, adverse effects)
  • Barbiturates (administration & dosage, adverse effects)
  • Dose-Response Relationship, Drug
  • Humans
  • Midazolam (administration & dosage, adverse effects)
  • Propofol (administration & dosage, adverse effects)
  • Respiratory Insufficiency (chemically induced, physiopathology)
  • Seizures (drug therapy, physiopathology)
  • Status Epilepticus (drug therapy, physiopathology)
  • Ventilator Weaning

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: