Anesthetic Management in Patients with Epilepsy
Keywords:epilepsy, anesthesia, anti-epileptic drugs, inhaled and intravenous anesthetics, epileptic seizures
Epilepsy is one of the most common neurological diseases and occurs in nearly 1 % of the world population. Patients with epilepsy require anesthetic management during planned or emergency surgical interventions, invasive diagnostic procedures, childbirth, dental care, and others. Anesthesia in patients with epilepsy has the features with the possibility of seizures during anesthesia and surgery. Preoperative management is important: finding the etiology, the type and frequency of seizures, the factors provoking the attack, regimen of antiepileptic drugs intake. Basic antiepileptic drugs can interact with other preparations, including anesthetics, to reduce their effectiveness, or on the contrary, to cause an increase in their blood concentration and the toxic side effects. General anesthetics (inhalational and intravenous) have a different effect on the epileptic processes in the brain. Some of them can induce epileptic seizures depending on their dose. The use of certain anesthetics may be recommended in patients with epilepsy, while the use of others — contraindicated. It is important not to miss the development of an epileptic seizure during anesthesia, which can be masked due to the use of muscle relaxants. Regional anesthesia in most cases can be safer than general anesthesia. In the postoperative period, receiving antiepileptic drugs should be resumed as quickly as possible. In the case of epileptic seizures in the perioperative period, their timely diagnosis and relief are important.
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