Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Masters, L. T. Articles by Nelson, P. K. Search for Related Content PubMed PubMed Citation Articles by Masters, L. T. Articles by Nelson, P. K.

American Journal of Neuroradiology 21:1302-1305 (7 2000)
© 2000 American Society of Neuroradiology

ARTICLE

Wada Testing in Pediatric Patients by Use of Propofol Anesthesia

Lynette T. Masters^a, Kenneth Perrine^a, Orrin Devinsky^a and Peter Kim Nelson^,a

^a From the Neurointerventional Service (LTM, PKN), Department of Radiology, and the Department of Neurology (KP, OD), New York University School of Medicine, New York University Medical Center, New York, NY.

BACKGROUND AND PURPOSE: Wada testing may provide important information for surgical planning in pediatric patients with medically refractory epilepsy, but it is often not used because of the difficulties in performing the angiographic portion of the procedure in conscious children. We reviewed our experience using propofol, a short-acting IV administered anesthetic agent, for pediatric patients undergoing Wada testing.

METHODS: In a retrospective review of Wada tests performed on patients younger than 18 years, we identified 24 cases in which propofol anesthesia was used. We reviewed the medical records of these patients, with particular reference to dose of propofol, physiological parameters during anesthesia, and adequacy of neuropsychological testing after emergence from anesthesia.

RESULTS: Patients ranged in age from 6 to 16 years (mean age, 12.5 years). Propofol induced mild reductions in blood pressure (12.4% for systolic and 13.9% for diastolic blood pressure) and heart rate (mean reduction of 4.7%), which did not require specific treatment in any patient. Recovery from anesthesia was smooth and rapid, allowing initiation of Wada testing within 15 to 25 minutes of cessation of propofol. Wada testing was successfully accomplished in all patients.

CONCLUSION: Propofol provided rapid induction of anesthesia, was administered without endotracheal intubation, and did not cause substantial changes in cardiorespiratory parameters. Propofol anesthesia allowed controlled angiography among patients as young as 6 years and did not interfere with neuropsychological testing.