Mae Zhang, Rory Vu Mather, Ashley R Chung, Chee Fai Andy Leung, Radhamangalam J Ramamurthi, Patrick L Purdon
{"title":"Electroencephalogram-Guided General Anesthesia in a Pediatric Patient With Alexander's Disease: A Case Report.","authors":"Mae Zhang, Rory Vu Mather, Ashley R Chung, Chee Fai Andy Leung, Radhamangalam J Ramamurthi, Patrick L Purdon","doi":"10.1213/XAA.0000000000001910","DOIUrl":null,"url":null,"abstract":"<p><p>In this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%. This highlights the potential impact of astrocyte dysfunction on anesthetic sensitivity and robustness of EEG as a biomarker of anesthetic effect, including for pediatric patients with rare neurodevelopmental diseases.</p>","PeriodicalId":56372,"journal":{"name":"A&A practice","volume":"19 1","pages":"e01910"},"PeriodicalIF":0.5000,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761024/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"A&A practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1213/XAA.0000000000001910","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
In this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%. This highlights the potential impact of astrocyte dysfunction on anesthetic sensitivity and robustness of EEG as a biomarker of anesthetic effect, including for pediatric patients with rare neurodevelopmental diseases.