Abstracts

Propofol is used in neuroanaesthesia because of its cerebroprotective properties. However, some authors reported seizures after the use of propofol in patients without epilepsy. We therefore investigated clinical and electrocorticographical alterations after propofol in patients with drug-resistant epilepsies using subdural electrodes for diagnostic preoperative focus localisation.
After institutional ethics approval and acquisition of written, informed consent, 28 patients (aged 18-54) enrolled in the study. Before removal of the electrodes in general anaesthesia we recorded heart rate (HR), noninvasive bloodpressure (BP syst, BP diast) and oxygensaturation (Sao2) 3 minutes before and for 5 minutes after injection of propofol 1.5 mg/kg. Simultaneously we documented any epileptic seizures and recorded electrocorticogramm (EcoG), and analysed this with respect to background activity, burst suppression, increase or decrease of spikes and spike burst suppression patterns.
There was no significant change in hemodynamical variables after propofol injection. No epileptic seizures were observed in any of the patients after injection of propofol. One minute after injection we recorded an increase of [beta]-frequency and later a burst suppression pattern in all of the patients. Additionally half of the patients exhibited spikes and spike burst suppression patterns.
Propofol was shown to prevent seizures in all of the patients. However, half of the patients showed an increase in seizure activity in EcoG readings. It is not known why seizure activity was found in certain patients but not others.