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Effect of Alfentanil on the Intraoperative Localization of an Epileptogenic Focus in Pediatric Patients with Intractable Seizure Disorder

Other Titles
 난치성 경련 질환 환아에서 Alfentanil이 간질 유발부위의 국소화에 미치는 영향 
Authors
 Byung In Choi  ;  Sung Jin Lee  ;  Seung Ho Choi  ;  Kyeong Tae Min  ;  Bahn Lee 
Citation
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.52(6) : 47-52, 2007 
Journal Title
 KOREAN JOURNAL OF ANESTHESIOLOGY 
ISSN
 2005-6419 
Issue Date
2007
Abstract
Background : Intraoperative alfentanil is known to increase the epileptic discharge in the adult seizure patients. This study hypothesized that alfentanil might localize an epileptogenic focus in pediatric seizure patients. Methods : This study was performed in the pediatric seizure patients who undergo second-staged operation. Thirteen pediatric patients were enrolled and their epileptic foci were already suspected from first operation. After anesthetic induction, sevoflurane was maintained at 0.6% end-tidal concentration for study period. Electrocorticography (ECoG) was recorded for 5 minutes before and 5 minutes after alfentanil 20µg/kg IV. During the ECoG recordings, the mean arterial pressure (MAP) and heart rate (HR) were continuously monitored. After the surgery, a pediatric neurologist analyzed the changes of spike frequencies of suspected ictal zone. The spike frequencies of suspected non-ictal zone were also calculated in five patients. The suspected ictal zone was defined as the most abundant spontaneous spiking area observed after first staged grid insertion. Results : Alfentanil induced a significant increase in spike activity of suspected ictal zone in 12 out of 13 patients (median of 20 [ranged 10 to 100] vs 38 [ranged 20 to 100], P < 0.05). Alfentanil-induced increase of spike activity was prominent in the suspected ictal zone rather than non-ictal zone. There were no significant changes in the MAP and HR after administration of alfentanil. Conclusions : Alfentanil activates epileptiform activity of suspected ictal zone in pediatric patients with seizure disorder and can be used to assist in the localization of the epileptogenic focus during seizure surgery.
Files in This Item:
T200700351.pdf Download
DOI
10.4097/kjae.2007.52.6.S47
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Min, Kyeong Tae(민경태) ORCID logo https://orcid.org/0000-0002-3299-4500
Lee, Sung Jin(이성진)
Choi, Byung In(최병인)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96829
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