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Unexpected neurological sequelae following propofol anesthesia in infants: Three case reports
Author(s):
P. Meyer
,
C. Langlois
,
S. Soëte
,
J. Leydet
,
B. Echenne
,
F. Rivier
,
A. Bonafé
,
A. Roubertie
Publication date
Created:
November 2010
Publication date
(Print):
November 2010
Journal:
Brain and Development
Publisher:
Elsevier BV
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PubMed
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Abstract
Propofol is a widely used hypnotic agent for induction and maintenance of pediatric anesthesia with a well known safety profile. Experimental in vitro studies suggest that propofol may be toxic to developing neurons. We report the cases of three infants who underwent surgery before 2 months of age for different benign pathologies. Propofol was used for induction and maintenance of anesthesia in all cases. The three patients developed convulsions with similar clinical characteristics (cluster of recurrent clinical and subclinical seizures) between the 23th and 30th hours following anesthesia. Clinical and electroencephalographic improvement was obtained between the third and fourth day of management in pediatric intensive care unit. The seizures never recurred, and the three patients underwent further uneventful general anesthesia without propofol. Follow-up of the three patients disclosed unexpected neurological dysfunction: progressive microcephaly (head circumferences were normal at birth), developmental impairment with cognitive and behavioural disturbances in two cases, and bilateral symmetrical white-matter abnormalities on cerebral magnetic resonance imaging. The causal relationship between propofol anesthesia and the neurological symptoms of our patients remains difficult to ascertain, but we believe that pediatricians, anesthetists and intensive care-givers should be aware of this possible adverse reaction that has never been described before. Copyright © 2009 Elsevier B.V. All rights reserved.
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Author and article information
Journal
Title:
Brain and Development
Abbreviated Title:
Brain and Development
Publisher:
Elsevier BV
ISSN (Print):
03877604
Publication date Created:
November 2010
Publication date (Print):
November 2010
Volume
: 32
Issue
: 10
Pages
: 872-878
Article
DOI:
10.1016/j.braindev.2009.11.011
PubMed ID:
20060673
SO-VID:
b42f1a42-2405-4d28-a2d7-c94f538a4977
Copyright ©
© 2010
License:
https://www.elsevier.com/tdm/userlicense/1.0/
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