THE PROBLEMS OF COOPERATION BETWEEN ANAESTHESIOLOGY , NEUROSURGERY AND FUNCTIONAL DIAGNOSTICS IN CASE OF EPILEPSY SURGERY

Abstract

The types of anaesthesia care for patients with drug-resistant epilepsy during stereotaxic operations for epilepsy pathways have been analyzed.Objective: to assess the adequacy of anesthesia and optimal values of EEG for total intravenous anesthesia based of Propofol, Midazolam and Fentanyl in stereotaxic operations for epilepsy.Materials and Methods. We enrolled 60 patients aged 17 to 35 years old. The study group included 40 patients with drug-resistant epilepsy while the control group consisted of 20 patients with brain tumors and epileptic seizures.Results. Comparative analysis of systemic hemodynamic parameters and adequacy of anaesthesia regimen revealed that total intravenous anaesthesia based on Propofol, Midazolam and Fentanyl at stage 3 on EEG by Courtin as an adequate protection from surgical stress decreasing the risk of intraoperative kindling without new foci of epileptic activity.Conclusion. The selected method of anesthesia provides electrophysiological identification of the focus of paroxysmal activity. It has been noted that a cooperation between a surgeon, an anesthesiologist and a neurophysiologist regarding stereotaxic operations for epilepsy is of great importance for successful operation.

Keywords

• drug-resistant epilepsy
• stereotaxic operation
• anaesthesiology
• electroencephalography
• stage of anaesthetic depth
• anesthesiological management