Pharmacy World and Science

, Volume 23, Issue 2, pp 82–85 | Cite as

Sharp transients in the EEGs of non‐epileptic adult patients receiving sevoflurane

  • Arthur Schultz
  • Barbara Schultz
  • Ulrich Grouven
  • Frank A. Beger
  • Gunter Korsch


Objective: In this article unexpected EEG findings are described which were observed during EEG monitoring under sevoflurane anesthesia.Method: In seven non‐epileptic adult patients sevoflurane was administered as inhalation anesthetic during routinely performed surgical operations. The EEG was recorded continuously as part of the standard monitoring process and served mainly as a dosage guide for anesthetics/narcotics.Main outcome measure: Occurrence of sharp transients in the EEG resembling distinctive waves which can be seen in epileptic disorders.Results: In six of the seven patients under 8.0 % sevoflurane, sharp transients were observed which appeared in very deep EEG stages, mostly with endtidal sevoflurane concentrations of 4.8 ‐ 5.9 %. The findings are in accordance with observations in non‐epileptic children from our clinic.Conclusions: The clinical significance of the observed EEG pattern under sevoflurane anesthesia is still unclear. Taking into consideration that convulsive and nonconvulsive status epilepticus can be followed by signs of brain damage, it would appear to be important to further investigate the phenomenon.

Adult patients EEG monitoring Sharp transients Sevoflurane 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hobbhahn J, Funk W. Sevofluran in der Kinderanästhesie. Anaesthesist 1996;45 (Suppl 1):S22-S27Google Scholar
  2. 2.
    Adachi M, Ikemoto Y, Kubo K, Takuma C. Seizure-like movements during induction of anaesthesia with sevoflurane. Brit J Anaesth 1992;68:214-5Google Scholar
  3. 3.
    Bösenberg AT. Convulsions and sevoflurane. Paediatr Anaesth 1997;7:477-8Google Scholar
  4. 4.
    Haga S, Shima T, Mormose K, Hashimoto Y. Anesthetic induction of children with high concentrations of sevoflurane. Masui 1992;41:1951-5Google Scholar
  5. 5.
    Komatsu H, Taie S, Endo S, Fukuda K, Ueki M, Nogaya J, Ogli K. Electrical seizures during sevoflurane anesthesia in two pediatric patients with epilepsy. Anesthesiology 1994;81:1535-7Google Scholar
  6. 6.
    Woodforth IJ, Hicks RG, Crawford MR, Stephen JPH, Burke DJ. Electroencephalographic evidence of seizure activity under deep sevoflurane anesthesia in a nonepileptic patient. Anesthesiology 1997;87(6):1579-82Google Scholar
  7. 7.
    Zacharias M. Convulsive movements with sevoflurane in children. Anaesthesia and Intensive Care 1997;25(6):727Google Scholar
  8. 8.
    Jasper HH. The ten-twenty electrode system of the International Federation. Electroenceph clin Neurophysiol 1958;10:371-5Google Scholar
  9. 9.
    Hobbhahn J, Schwall B, Hoerauf K, Koppenberg J, Englmeier C, Mrotzek T, Taeger K. DeInhalativeEinleitung mit Sevofluran bei Erwachsenen-Effektivität, Sicherheit, Patientenakzeptanz und Arbeitsplatzkonzentrationen. Anaesth Intensivmed 1998;3:118-24Google Scholar
  10. 10.
    Muzi M, Robinson BJ, Elbert TJ, O'Brien TJ. duction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996;85:536-43Google Scholar
  11. 11.
    Sloan MH, Conard PF, Karsunky PK, Gross JB. Sevoflurane versus isoflurane: induction and recovery characteristics with single-breath inhaled inductions of anesthesia. Anesth Analg 1996;82:528-32Google Scholar
  12. 12.
    Thwaites A, Edmends S, Smith I. Inhalation induction with sevoflurane: a double-blind comparison with propofol. Brit J Anesth 1997;78:356-61Google Scholar
  13. 13.
    Yurino M, Kimura H. Comparison of induction time and characteristics between sevoflurane and sevoflurane/nitrous oxide. Acta Anaesthesiol Scand 1995;39:356-8Google Scholar
  14. 14.
    Yurino M, Kimura H. A comparison of vital capacity breath and tidal breathing techniques for induction of anaesthesia with high sevoflurane concentrations in nitrous oxide and oxygen. Anaesthesia 1995;50:308-11Google Scholar
  15. 15.
    Wasterlain CG, Fujikawa DG, Penix L, Sankar R. Pathophysioloical mechanisms of brain damage from status epilepticus. Epilepsia 1993;34 (Suppl. 1):S37-S53Google Scholar
  16. 16.
    Terasako K, Ishii S. Postoperative seizure-like activity following sevoflurane anesthesia. Acta Anaesthesiol Scand 1996;40:953-4Google Scholar
  17. 17.
    Avramov MN, Shingu K, Omatsu Y, Osawa M, Mori K. Effects of different speeds of induction with sevoflurane on the EEG in man. J Anesth 1987;1:1-7Google Scholar
  18. 18.
    Schultz B, Schultz A. Epileptiform EEG potentials with sevoflurane. Anaesthesia and Intensive Care 1998;26:329Google Scholar
  19. 19.
    Schultz B, Schultz A, Lüllwitz E, Grouven U, Korsch G. DeEpilepsietypische Potentiale im EEG von Kindern während Sevofluran-Narkosen. In: Bentele KHP, Kohlschütter A (eds.), Aktuelle Neuropädiatrie 1998. Nürnberg: Novartis, 1999:235-8Google Scholar
  20. 20.
    Kaisti KK, Jääskeläinen SK, Rinne JO, Metsähonkala L, Scheinin H. Epileptiform discharges during 2 MAC sevoflurane anesthesia in two healthy volunteers. Anesthesiology 1999;91:1952-5Google Scholar
  21. 21.
    Yli-Hankala A, Vakkuri A, Särkelä M, Lindgren L, Korttila K, Jäntti V. Epileptiform electroencephalogram during mask induction of anesthesia with sevoflurane. Anesthesiology 1999;91:1596-603Google Scholar
  22. 22.
    Modica PA, Tempelhoff R, White PF. Pro-and anticonvulsant effects of anesthetics (part I). Anesth Analg 1990;70:303-15Google Scholar
  23. 23.
    Rote Liste® Service GmbH (ed.). Rote Liste 2000. Aulendorf: Editio Cantor, 2000:65 001Google Scholar
  24. 24.
    Walder B, Seeck M, Tramèr MR. Pro-and anticonvulsive effects of propofol: a systematic review. Eur J Anaesthesiol 2000; 17 (Suppl 19):84Google Scholar
  25. 25.
    Watts ADJ, Herrick IA, McLachlan RS, Craen RA, Gelb AW. The effect of sevoflurane and isoflurane anesthesia on interictal spike activity among patients with refractory epilepsy. Anesth Analg 1999;89:1275-81Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Arthur Schultz
    • 1
  • Barbara Schultz
    • 1
  • Ulrich Grouven
    • 1
  • Frank A. Beger
    • 1
  • Gunter Korsch
    • 1
  1. 1.Medizinische Hochschule Hannover, Abt. Anaesthesie IV, Klinikum Hannover ‐ OststadtHannoverGermany

Personalised recommendations