Propofol in the treatment of refractory status epilepticus.

OBJECTIVES

To study prospectively the effects of propofol anesthesia on seizure control, hemodynamics and course of intensive care in patients with refractory status epilepticus.

DESIGN AND SETTING

Prospective observational study in the general intensive care unit in a tertiary university hospital.

PATIENTS

Ten patients with refractory status epilepticus.

INTERVENTIONS

Patients received propofol anesthesia aiming to burst suppression EEG pattern for 12 h.

MEASUREMENTS AND RESULTS

Dose of propofol, quality of burst suppression EEG, hemodynamics and the course of intensive care were recorded. Clinical and electrophysiological seizures terminated quickly, but maintaining burst suppression EEG pattern required incremental doses of propofol. Despite high doses of propofol, recovery from anesthesia was fast.

CONCLUSIONS

High doses of propofol are needed in the treatment of refractory status epilepticus. The maintenance of continuous-burst suppression is difficult, and vigilant titrating of dosage of propofol is necessary under continuous EEG monitoring.