Effets électroencéphalographiques du sévoflurane à l’induction chez le jeune enfant : étude prospective sur 20 cas

Abstract

Objective: To study electroencephalographic (EEG) changes in children during 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 ; written informed consent obtained from parents ; anaesthesia induced with 8% sevoflurane in oxygen ; no premedication was given ; to collect the EEG data, non-invasive electodes were installed before induction ; EEG was recorded continuously and stored on a computer for later analyses (descriptive analysis). Results: Myoclonics movements were observed during induction of anaesthesia in two boys. Myoclonics movements stopped spontaneously without therapy. Epileptiform EEG activity (spikes and poly-spikes, burst suppression) was observed. In the 18 others cases, during sevoflurane induction, EEG changed rapidly with an increase in the range of beta activity (> 13 Hz) ( n=15) and 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-voltage slow waves). Periods of EEG isoelectrical (burst suppression) were seen without spikes in four cases. Conclusion: At 2 MAC, epileptiform EEG activity has been observed during sevoflurane anaesthesia. In a short group of patients, this raises the question of avoiding sevoflurane in patients who have a history of epilepsy.