ArticleAnesthesiology2012
Epileptogenic effect of sevoflurane: determination of the minimal alveolar concentration of sevoflurane associated with major epileptoid signs in children.
Article in Anesthesiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pharmacokinetic/Pharmacodynamic Model of Propofol in Children
Emergence Delirium in Children: a Randomized Clinical Trial of Different Doses of Sevoflurane During Induction of Anesthesia
Influence of Volatile Induction of General Anaesthesia With Sevoflurane Using Two Different Techniques and Intravenous Induction Using Propofol on the Epileptiform Electroencephalograph Patterns:
EEG-based Depth of Anesthesia-monitoring During General Anesthesia - Effects on Time to Wake-up and Post-operative Cognition
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Epileptiform discharges, electrographic seizures, and electroclinical seizures during paediatric sevoflurane anaesthesia: a systematic review and proposal for standard definitions.British journal of anaesthesia · 2023Pooled it
- High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia.The Cochrane database of systematic reviews · 2016Pooled it
- Comparing different administration methods of subanaesthetic propofol to mitigate emergence agitation in preschool children undergoing day surgery: a double-blind, randomised controlled study.BMJ paediatrics open · 2025Trial
- Intranasal Esketamine Premedication Reduces Sevoflurane Requirements During Laryngeal Mask Airway Insertion in Pediatric Patients: A Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- Sevoflurane-induced isoelectric EEG and burst suppression: differential and antagonistic effect of added nitrous oxide.Anaesthesia · 2017Trial
- Gyosaponin ameliorates sevoflurane anesthesia-induced cognitive dysfunction and neuronal apoptosis in rats through modulation of the PI3K/AKT/mTOR pathway.Clinics (Sao Paulo, Brazil) · 2025Article
- Normative high-frequency oscillation phase-amplitude coupling and effective connectivity under sevoflurane.Brain communications · 2025Article
- Inhaled Anesthetics: Beyond the Operating Room.Journal of clinical medicine · 2024Review
- SHARPIN contributes to sevoflurane-induced neonatal neurotoxicity through up-regulating HMGB1 to repress M2 like-macrophage polarization.Metabolic brain disease · 2024Article
- Translatome and transcriptome profiling of neonatal mice hippocampus exposed to sevoflurane anesthesia.Heliyon · 2024Article
- Sevoflurane-induced high-frequency oscillations, effective connectivity and intraoperative classification of epileptic brain areas.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2023Article
- Impact of Sevoflurane and Thiopental Used Over the Course of Electroconvulsive Therapy: Propensity Score Matching Analysis.Frontiers in human neuroscience · 2022Article
- Urinary Aromatic Amino Acid Metabolites Associated With Postoperative Emergence Agitation in Paediatric Patients After General Anaesthesia: Urine Metabolomics Study.Frontiers in pharmacology · 2022Article
- Repeated neonatal sevoflurane induced neurocognitive impairment through NF-κB-mediated pyroptosis.Journal of neuroinflammation · 2021Article
- Gut microbiota mediates cognitive impairment in young mice after multiple neonatal exposures to sevoflurane.Aging · 2021Article
- Case report and review of literature of a rare congenital disorder: Adams-Oliver syndrome.BMC anesthesiology · 2021Review
- Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction.Frontiers in aging neuroscience · 2021Review
- High Incidence of Epileptiform Potentials During Continuous EEG Monitoring in Critically Ill COVID-19 Patients.Frontiers in medicine · 2021Article
- Emergence agitation: current knowledge and unresolved questions.Korean journal of anesthesiology · 2020Review
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevoflurane has become the gold standard for inhalation induction in children. However in children as in adults, epileptiform electroencephalographic signs have been described under high concentrations of sevoflurane. The aim of this study was to determine the minimal alveolar concentration (MAC) of sevoflurane associated with the occurrence of major epileptiform signs (MES) in 50% children under steady-state conditions. The MAC of MES (MAC MES) was determined in 100% oxygen and with the addition of 50% nitrous oxide or after the injection of alfentanil (ALFENTA).
methodsSeventy-nine children (3-11 yr), undergoing elective surgery and premedicated with hydroxyzine were included. After induction by inhalation and tracheal intubation, a 10-min period with a stable expired fraction of sevoflurane was obtained. The MES were defined as rhythmic polyspikes or epileptiform discharges. Electroencephalographic recordings were blindly analyzed by two independent experts. The MAC MES were determined by the Dixon method: the concentration of sevoflurane was determined by the result from the previous patient: increase of 0.2% if MES were absent or decrease of 0.2% if MES were present. Three consecutive series were performed: (1) in 100% oxygen (MAC MESO2); (2) in 50% oxygen and 50% nitrous oxide (MAC MESN2O); and (3) in 100% oxygen with a bolus of alfentanil (MAC MESALFENTA).
resultsThe MAC MESO2 was 4.3±0.1% (mean±SD), the MAC MESN2O and the MAC MESALFENTA were higher, respectively: 4.6±0.2% (P=0.01) and 4.6±0.2% (P=0.02).
conclusionsIn children premedicated with hydroxyzine, the MAC MES of sevoflurane calculated in 100% O2 corresponded to 1.75 surgical MAC. In addition, our results have demonstrated a moderate effect of nitrous oxide and alfentanil in raising the threshold of MES.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.