Sevoflurane for the treatment of refractory status epilepticus in the critical care unit

anaesthesiacases.org June 21, 2018

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A 50-year-old woman with liver failure was admitted to critical care for refractory status epilepticus (RSE). Following tracheal intubation, sevoflurane was administered via the MIRUS system (Pall Medical, Dreieich, Germany). Following incremental increases in minimum alveolar concentration (MAC) from 0.3 to 1.0, there was a suppression of motor activity and continuous electroencephalogram (EEG) monitoring revealed suppression of seizure activity. Sevoflurane was progressively reduced to 0.3 MAC and the EEG recovered. Forty-eight hours later, sevoflurane was discontinued followed by extubation. The patient was discharged from hospital a further 48 hours later.