Department of Anesthesiology, All India Institute of Medical Sciences Patna, Bihar, India.
Department of Trauma & Emergency, All India Institute of Medical Sciences Patna, Bihar, India.
Korean J Anesthesiol. 2021 Feb;74(1):70-72. doi: 10.4097/kja.20162. Epub 2020 May 11.
Status epilepticus, when continued despite the administration of two antiepileptic drugs, is called refractory status epilepticus (RSE). The seizure-like phenomenon due to propofol is widely reported in the literature. However, RSE caused by propofol is rare and is a diagnostic dilemma.
A 44-year-old male patient presented with RSE during the intraoperative period and was under general anesthesia on propofol infusion. The seizure was resistant to benzodiazepines and phenytoin. Thereafter, the seizure subsided after the discontinuation of propofol infusion, and the patient was shifted to fentanyl and dexmedetomidine infusion for the maintenance of anesthesia. The postoperative follow-up was uneventful.
This article focuses on the management of intractable intraoperative seizure and highlights the need for the exploration of seizure characteristics caused by propofol.
癫痫持续状态，即尽管使用了两种抗癫痫药物仍持续发作，被称为难治性癫痫持续状态（RSE）。在文献中有广泛报道丙泊酚引起的癫痫样现象。然而，丙泊酚引起的 RSE 很少见，是一个诊断难题。
一名 44 岁男性患者在手术期间出现 RSE，并接受丙泊酚输注全身麻醉。该患者对苯二氮䓬类药物和苯妥英钠耐药。此后，停用丙泊酚输注后，癫痫发作缓解，患者转为芬太尼和右美托咪定输注维持麻醉。术后随访顺利。
本文重点介绍了难治性术中癫痫发作的处理方法，并强调需要探索丙泊酚引起的癫痫发作特征。
