Challenging anesthesia of the patient on ketogenic diet therapy scheduled for scoliosis surgery under motor evoked potentials monitoring: a case report
| Authors | |
|---|---|
| Year of publication | 2023 |
| Type | Article in Periodical |
| Magazine / Source | JOURNAL OF ANESTHESIA |
| MU Faculty or unit | |
| Citation | |
| Web | https://link.springer.com/article/10.1007/s00540-023-03226-z |
| Doi | http://dx.doi.org/10.1007/s00540-023-03226-z |
| Keywords | Motor evoked potentials; Midazolam; Remifentanil; Total intravenous anesthesia; Case report |
| Attached files | |
| Description | Although propofol represents a “gold standard” from anesthetic drugs for total intravenous anesthesia (TIVA) with intraoperative neurophysiological monitoring (IONM), the anesthetic team should have an alternative plan in rare cases when the propofol is contraindicated, and remimazolam, a new ultra-short-acting benzodiazepine, is not available. We describe a patient suffering from glucose transporter type 1 deficiency syndrome (Glut1DS) with the history of epilepsy treated by ketogenic diet therapy (KDT) scheduled for scoliosis surgery under IONM. The prolonged propofol administration was contraindicated due to high doses of carbohydrates contained in propofol that may worsen epilepsy. In rare cases, prolonged propofol infusion can lead to propofol infusion syndrome (PRIS) in patients on KDT, and that is why anesthetic team has to prepare an alternative management to allow quality IONM. |
| Related projects: |