Electroencephalographic effects of sevoflurane in paediatric anaesthesia: a prospective study of 20 cases.

Objective: To study electroencephalographic (EEG) changes in children durin g induction of anaesthesia with 8% sevoflurane. Patients: Twenty patients were consecutively included (ASA I-II; aged : 13- 101 months). Material and method: Prospective study; approved by the Ethics Committee;wr itten informed consent obtained from parents; anaesthesia induced with 8% s evoflurane in oxygen; no premedication was given; to collect the EEG data, non-invasive electodes were installed before induction; EEG was recorded co ntinuously and stored on a computer for later analyses (descriptive analysi s). Results: Myoclonics movements were observed during induction of anaesthesia in two boys. Myoclonics movements stopped spontaneously without therapy. E pileptiform EEG activity (spikes and poly-spikes, burst suppression) was ob served. In the 18 others cases, during sevoflurane induction, EEG changed r apidly with an increase in the range of beta activity (> 13 Hz) (n = 15) an d in slow (< 8 Hz) and delta activity (< 4 Hz). In 14 patients, at time of laryngoscopy, the EEGs showed monophasic slow data activity (sharp high-vol tage slow waves). Periods of EEG isoelectrical (burst suppression) were see n without spikes in four cases. Conclusion: At 2 MAC, epileptiform EEG activity has been observed during se voflurane anaesthesia. In a short group of patients, this raises the questi on of avoiding sevoflurane in patients who have a history of epilepsy. (C) 2001 Editions scientifiques et medicales Elsevier SAS.