Propofol induced severe neuroexcitatory symptoms during emergency laparotomy

Authors

  • Puneet K. Banga Department of Anesthesiology and Critical Care, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun-248001, India
  • Shalini Dadu Department of Anesthesiology and Critical Care, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun-248001, India
  • Madhuri Sharma Department of Anesthesiology and Critical Care, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun-248001, India

Keywords:

Propofol, Seizures, Neuroexcitatory symptoms

Abstract

Propofol is a widely used intravenous agent for general anesthesia and sedation. Propofol is associated with a variety of neuroexcitatory events including: opisthotonus, muscle rigidity, myoclonus, and seizures collectively termed as seizure-like phenomenon (SLP). We report a rare case of propofol   induced severe neuroexcitatory symptoms at the time of induction in a young male presenting for emergency laparotomy. He developed generalized tonic- clonic seizures which resulted in dislodgement of intravenous cannula. Immediately a new intravenous cannula was inserted with difficulty during convulsions and injection thiopentone 200 mg bolus was given. Convulsions subsided within a minute. Patient remained hemodynamically stable and surgery was uneventful. He developed emergence agitation which was treated with injection midazolam. Patient recovered with no neurologic sequelae.

References

Jung SH, Kim TW, Jung KY, Kim JM. A case of propofol-induced seizure-like phenomena. Korean J Epilepsy Soc 2003;7:51-53.

Walder B, Tramer MR, Seeck M. Seizure like phenomenon and Propofol: A systematic review. Neurology 2002;58:1327-32.

Baraka A, Aouad M. Is propofol anticonvulsant or proconvulsant? Can J Anaesth 1997;44:1027-9.

Hewitt PB, Chu DL, Polkey CE, Binnie CD. Effect of propofol on the electrocorticogram in epileptic patients undergoing cortical resection. Br J Anaesth 1999;82:199-202.

Rossetti AO, Reichharty MD, Schaller MD, Despland PA, Bogousslavsky J. Propofol treatment of refractory status epilepticus: A study of 31 episodes. Epilepsia 2004;45:757-63.

Reynolds LM, Koh JL. Prolonged spontaneous movement following emergence from propofol/nitrous oxide anesthesia. Anesth Analg 1993;73:192-3.

Islander G, Vinge E. Severe neuroexcitatory symptoms after anaesthesia-with focus on propofol anaesthesia. Acta Anaesthesiol Scand 2000;44:144-9.

Sutherland MJ, Burt P. Propofol and seizures. Anaesth Intensive Care 1994;22:733-7.

Rath GP, Bithal PK, Prabhakar H. Propofol induced myoclonus may dislodge laryngeal mask airway. Indian J Anaesth 2006;50:45-6.

Finely GA, MacManus B, Sampson SE, Fernandez CV, Retallick R. Delayed seizures following sedation with propofol. Can J Anaesth 1993:40:863-5.

Downloads

Published

2017-02-01

How to Cite

Banga, P. K., Dadu, S., & Sharma, M. (2017). Propofol induced severe neuroexcitatory symptoms during emergency laparotomy. International Journal of Basic & Clinical Pharmacology, 2(5), 645–646. Retrieved from https://www.ijbcp.com/index.php/ijbcp/article/view/1334