Preliminary results of an incremental intracarotid amobarbital procedure: Evaluation of language and memory without sedation

Abstract

To evaluate the effects of performing the intracarotid amobarbital procedure (IAP) using an incremental injection, the results obtained using this technique in seven patients were compared to the findings in a second group of seven patients who received a bolus injection of amobarbital, which was typically 100 mg. Videotapes of each IAP were rated by two observers for level of sedation using a modified version of the Reaction Level Scale. The bolus procedure used a higher dosage and produced significantly greater sedation as compared to the incremental IAP. The incremental IAP also revealed linguistic errors and/or speech arrest, which identified the hemisphere specialized for language. Memory for material introduced during the drug phase was significantly impaired in the epileptogenic hemisphere as compared to the intact hemisphere in the group receiving an incremental injection of sodium amobarbital. Pending replication of this preliminary study, these preliminary findings provide support for the efficacy of using incremental IAP to mitigate sedation.