Practical considerations on epilepsy and anesthetic management
DOI:
https://doi.org/10.37135/ee.004.01.09Keywords:
epilepsy, pharmaceutical preparations, patient care managementAbstract
Epilepsy, disease characterized by the alteration of brain electrical activity. Epileptic seizures are classified: partial, generalized and unknown. The diagnosis is established through clinical correlation and electroencephalography. The maintenance antiepileptic treatment depends on the specific type of crisis. The epileptic status constitutes the persistence of a convulsive crisis for more than five minutes (for clinical effects) that requires intensive pharmacological management with benzodiazepines, phenytoin, phenobarbital and other medications. The behavior and management of the anesthetic procedure in the context of a patient with epilepsy requires an adequate preoperative assessment in order to research the existence of comorbidities, characteristics of the seizures, pharmacotherapy received and their interactions with certain anesthetic agents. The administration of those anesthetics with proconvulsivantes effects (etomidato, ketamine, enflurano, sevoflurane, fentanyl, alfentanil, remifentanil, meperidina, among others) should be avoided in epileptic patients. Benzodiazepines, thiopental, propofol, isofuran, halothane, desflurane, among others are considered as safe anesthetic agents.
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