Propofol treatment of refractory status epilepticus: a study of 31 episodes.

Détails

ID Serval
serval:BIB_49AF96CE8399
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Propofol treatment of refractory status epilepticus: a study of 31 episodes.
Périodique
Epilepsia
Auteur⸱e⸱s
Rossetti A.O., Reichhart M.D., Schaller M.D., Despland P.A., Bogousslavsky J.
ISSN
0013-9580
Statut éditorial
Publié
Date de publication
2004
Peer-reviewed
Oui
Volume
45
Numéro
7
Pages
757-763
Langue
anglais
Notes
Comparative Study Journal Article --- Old month value: Jul
Résumé
PURPOSE: Refractory status epilepticus (RSE) is a critical medical condition with high mortality. Although propofol (PRO) is considered an alternative treatment to barbiturates for the management of RSE, only limited data are available. The aim of this study was to assess PRO effectiveness in patients with RSE. METHODS: We retrospectively considered all consecutive patients with RSE admitted to the medical intensive care unit (ICU) between 1997 and 2002 treated with PRO for induction of EEG-monitored burst suppression. Subjects with anoxic encephalopathy showing pathological N20 on somatosensory evoked potentials were excluded. RESULTS: We studied 31 RSE episodes in 27 adults (16 men, 11 women; median age, 41.5 years). All patients received PRO, and six also subsequently thiopental (THP). Clonazepam (CZP) was administered with PRO, and other antiepileptic drugs (AEDs) concomitant with PRO and THP. RSE was successfully treated with PRO in 21 (67%) episodes and with THP after PRO in three (10%). Median PRO injection rate was 4.8 mg/kg/h (range, 2.1-13), median duration of PRO treatment was 3 days (range, 1-9), and median duration of ICU stay was 7 days (range, 2-42). In 24 episodes in which the patient survived, shivering after general anesthesia was seen in 10 episodes, transient dystonia and hyperlipemia in one each, and mild neuropsychological impairment in five. The seven deaths were not directly related to PRO use. CONCLUSIONS: PRO administered with CZP was effective in controlling most of RSE episodes, without major adverse effects. In this setting, PRO may therefore represent a valuable alternative to barbiturates. A randomized trial with these drug classes could definitively assess their respective role in RSE treatment.
Mots-clé
Adult, Anesthetics, Intravenous, Anticonvulsants, Clonazepam, Coma, Dose-Response Relationship, Drug, Drug Therapy, Combination, Electroencephalography, Female, Humans, Infusions, Intravenous, Male, Monitoring, Physiologic, Propofol, Retrospective Studies, Status Epilepticus, Thiopental, Treatment Outcome
Pubmed
Web of science
Open Access
Oui
Création de la notice
25/01/2008 12:40
Dernière modification de la notice
20/08/2019 14:57
Données d'usage