PENTOBARBITAL THERAPY FOR STATUS EPILEPTICUS IN CHILDREN - TIMING OF TAPERING

Three children with refractory status epilepticus, unresponsive to int ravenous administration of diazepam, phenytoin, and lidocaine, receive d pentobarbital therapy and were monitored by electroencephalography ( EEG). They required mechanical ventilation and vasopressor therapy. In travenous pentobarbital therapy was successful and without distinct se quelae in all 3 patients, and could be incrementally discontinued with out breakthrough seizures after 12-65 hours of a burst-suppression or complete suppression pattern on EEG. Obtaining a suppression pattern w as important for controlling status epilepticus in children as well as adults. We suggest that 12 hours after a burst-suppression pattern is obtained, tapering of pentobarbital should be attempted to avoid seri ous complications of extended pentobarbital anesthesia (e.g., respirat ory depression, hypotension, pneumonia).