Burst Suppression by Using Combined Inhaled Sevoflurane and Propofol in Postoperative Period in Patient with Refractory Intracranial Hypertension: A Case Report
Keywords:
refractory intracranial hypertension, barbiturates coma, inhaled sevoflurane, anesthetic conserving deviceAbstract
Background: Barbiturate coma are widely used in postoperative period in patient with refractory intracranial hypertension for deep state of brain inactivation. Inhaled sevoflurane via the anesthetic conserving device could be useful for the sedation of patients in the intensive care unit, but few evidence support to this procedure.
Main Content: A 53-year-old man had glioblastoma multiforme at left temporal lobe presented with confusion 4 days ago and developed epilepsy. He was planned to performed craniotomy with tumor removal during Intra-operative found intractable cerebral edema then his clinical progressed to uncontrolled intracranial hypertension and refractory status epilepticus. inhaled sevoflurane administration was performed to decrease dose of propofol for maintain hemodynamics. Intractable cerebral edema and status epilepticus was successfully treated in this patients.
Conclusion: The use of inhaled sevoflurane reduced opioid dose intensity , promote resolving from status epilepticus, decrease dose of vasopressor to maintain hemodynamics and no adverse events.
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