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Case 35 - Epilepsysurgery: intraoperative seizure

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

By
Oren Sagher  and
Shawn L. Hervey-Jumper
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

Epilepsy is a complex disease that imposes great disability on those affected. Epilepsy surgery is an underutilized treatment option and an awake craniotomy is sometimes warranted to allow precise cortical mapping. This chapter presents a case study of a 20-year-old healthy male with a history of seizure disorder who was found to have a right frontal brain tumor. The primary concerns of the anesthesiology team were: (1) management of intraoperative pain, particularly during Mayfield cranial pin placement, (2) management of the airway, (3) the potential for nausea and vomiting, and (4) intraoperative seizures during cortical stimulation. The patient was brought to the operating room and brief sedation was induced using a propofol and alfentanil infusion. There are several pitfalls for which anesthesiologists should be aware, close monitoring, team communication, the safe and judicious use of long-acting local analgesia and prompt management of intraoperative seizures make for safe perioperative care.

Keywords

vascular surgerycoronary artery diseasemyocardial infarctionperioperative managementcarotid endarterectomiesanesthesiacardiac risk
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 110 - 112
Publisher: Cambridge University Press
Print publication year: 2011

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