Consideraciones prácticas sobre epilepsia y manejo anestésico
Journal Title: Revista Eugenio Espejo - Year 2016, Vol 10, Issue 2
Abstract
Epilepsy is a disease characterized by the alteration of brain electrical activity. Epileptic seizures are classified into three groups: 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 that have shown proconvulsivantes effects (etomidato, ketamine, enflurano, sevoflurane, fentanyl, alfentanil, remifentanil, meperidina, among others) should be avoided in epileptic patients. Benzodiazepines, thiopental, propofol (despite its proconvulsive effect in some cases), isofuran, halothane, desflurane, among others are considered as safe anesthetic agents.
Authors and Affiliations
Karen Viviana Sierra Parrales Universidad San Francisco de Quito, Ecuador Daniela Elizabeth Miñaca Rea Universidad San Francisco de Quito, Ecuador Iván Wladimir Galarza Altamirano Universidad San Francisco de Quito, Ecuador
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