Xenon as an anesthetic of choice for full mouth debridement in a child with drug-resistant epilepsy: A clinical case

Abstract

Background: Outpatient dental care in children with epilepsy (particularly drug-resistant epilepsy) is challenging for anesthesiologists in terms of selecting appropriate anesthesia methods and agents, as well as for dentists in terms of improving treatment efficacy and quality while minimizing intervention time. General anesthetics may trigger seizures in patients with epilepsy, including those with drug-resistant epilepsy. As a result, selecting the appropriate anesthetic is critical during preparation stages and anesthetic management in these patients.

Case description: A clinical case of full mouth debridement in a 3-year-old child with drug-resistant epilepsy is presented to demonstrate the efficacy of xenon as an inhalational anesthetic in patients with drug-resistant epilepsy. Combination inhalation anesthesia with xenon was used.

There were no signs of seizures during surgery and within two days after anesthesia.

Conclusion: Xenon may be a viable inhalational anesthetic for patients with drug-resistant epilepsy.

Keywords

anesthesia / xenon / drug-resistant epilepsy / children / dentistry

References

[1] Miao M, Han Y, Zhang Y, et al. Epileptiform EEG discharges during sevoflurane anesthesia in children: A meta-analysis. Clin Neurophysiol. 2022;143:48–55. doi: 10.1016/j.clinph.2022.08.019

[2] Miao M., Han Y., Zhang Y., et al. Epileptiform EEG discharges during sevoflurane anesthesia in children: A meta-analysis // Clin Neurophysiol. 2022. Vol. 143. P. 48–55. doi: 10.1016/j.clinph.2022.08.019

[3] Tanaka S, Oda Y, Ryokai M, et al. The effect of sevoflurane on electrocorticographic spike activity in pediatric patients with epilepsy. Paediatr Anaesth. 2017;27(4):409–416. doi: 10.1111/pan.13111

[4] Tanaka S., Oda Y., Ryokai M., et al. The effect of sevoflurane on electrocorticographic spike activity in pediatric patients with epilepsy // Paediatr Anaesth. 2017. Vol. 27, N 4. P. 409–416. doi: 10.1111/pan.13111

[5] Vakkuri A, Yli-Hankala A, Särkelä M, et al. Sevoflurane mask induction of anaesthesia is associated with epileptiform EEG in children. Acta Anaesthesiol Scand. 2001;45(7):805–811. doi: 10.1034/j.1399-6576.2001.045007805.x

[6] Vakkuri A., Yli-Hankala A., Särkelä M., et al. Sevoflurane mask induction of anaesthesia is associated with epileptiform EEG in children // Acta Anaesthesiol Scand. 2001. Vol. 45, N 7. P. 805–811. doi: 10.1034/j.1399-6576.2001.045007805.x

[7] Liu XY, Shi T, Yin WN, et al. Interictal epileptiform discharges were associated with poorer cognitive performance in adult epileptic patients. Epilepsy Res. 2016;128:1–5. doi: 10.1016/j.eplepsyres.2016.09.022

[8] Liu X.Y., Shi T., Yin W.N., et al. Interictal epileptiform discharges were associated with poorer cognitive performance in adult epileptic patients // Epilepsy Res. 2016. Vol. 128. P. 1–5. doi: 10.1016/j.eplepsyres.2016.09.022

[9] Lu L, Xiong W, Zhang Y, et al. Propofol-induced refractory status epilepticus at remission age in benign epilepsy with centrotemporal spikes: A case report and literature review. Medicine (Baltimore). 2019;98(27):e16257. doi: 10.1097/MD.0000000000016257

[10] Lu L., Xiong W., Zhang Y., et al. Propofol-induced refractory status epilepticus at remission age in benign epilepsy with centrotemporal spikes: A case report and literature review // Medicine (Baltimore). 2019. Vol. 98, N 27. P. e16257. doi: 10.1097/MD.0000000000016257

[11] Perucca E, Perucca P, White HS, Wirrell EC. Drug resistance in epilepsy. Lancet Neurol. 2023;22(8):723–734. doi: 10.1016/S1474-4422(23)00151-5

[12] Perucca E., Perucca P., White H.S., Wirrell E.C. Drug resistance in epilepsy // Lancet Neurol. 2023. Vol. 22, N 8. P. 723–734. doi: 10.1016/S1474-4422(23)00151-5

[13] Korsunsky G. Xenon. Int Anesthesiol Clin. 2015;53(2):40–54. doi: 10.1097/AIA.0000000000000049

[14] Korsunsky G. Xenon // Int Anesthesiol Clin. 2015. Vol. 53, N 2. P. 40–54. doi: 10.1097/AIA.0000000000000049

[15] Maze M, Laitio T. Neuroprotective properties of xenon. Mol Neurobiol. 2020;57(1):118–124. doi: 10.1007/s12035-019-01761-z

[16] Maze M., Laitio T. Neuroprotective properties of xenon // Mol Neurobiol. 2020. Vol. 57, N 1. P. 118–124. doi: 10.1007/s12035-019-01761-z

[17] Zhang Y, Zhang M, Liu S, et al. Xenon exerts anti-seizure and neuroprotective effects in kainic acid-induced status epilepticus and neonatal hypoxia-induced seizure. Exp Neurol. 2019;322:113054. doi: 10.1016/j.expneurol.2019.113054

[18] Zhang Y., Zhang M., Liu S., et al. Xenon exerts anti-seizure and neuroprotective effects in kainic acid-induced status epilepticus and neonatal hypoxia-induced seizure // Exp Neurol. 2019. Vol. 322. P. 113054. doi: 10.1016/j.expneurol.2019.113054

[19] Hanada T. Ionotropic Glutamate receptors in epilepsy: a review focusing on AMPA and NMDA receptors. Biomolecules. 2020;10(3):464. doi: 10.3390/biom10030464

[20] Hanada T. Ionotropic glutamate receptors in epilepsy: a review focusing on AMPA and NMDA receptors // Biomolecules. 2020. Vol. 10, N 3. P. 464. doi: 10.3390/biom10030464

[21] Campos-Pires R, Hirnet T, Valeo F, et al. Xenon improves long-term cognitive function, reduces neuronal loss and chronic neuroinflammation, and improves survival after traumatic brain injury in mice. Br J Anaesth. 2019;123(1):60–73. doi: 10.1016/j.bja.2019.02.032

[22] Campos-Pires R., Hirnet T., Valeo F., et al. Xenon improves long-term cognitive function, reduces neuronal loss and chronic neuroinflammation, and improves survival after traumatic brain injury in mice // Br J Anaesth. 2019. Vol. 123, N 1. P. 60–73. doi: 10.1016/j.bja.2019.02.032

[23] Zhao CS, Li H, Wang Z, Chen G. Potential application value of xenon in stroke treatment. Med Gas Res. 2018;8(3):116–120. doi: 10.4103/2045-9912.241077

[24] Zhao C.S., Li H., Wang Z., Chen G. Potential application value of xenon in stroke treatment // Med Gas Res. 2018. Vol. 8, N 3. P. 116–120. doi: 10.4103/2045-9912.241077

[25] Zhang M, Cui Y, Cheng Y, et al. The neuroprotective effect and possible therapeutic application of xenon in neurological diseases. J Neurosci Res. 2021;99(12):3274–3283. doi: 10.1002/jnr.24958

[26] Zhang M., Cui Y., Cheng Y., et al. The neuroprotective effect and possible therapeutic application of xenon in neurological diseases // J Neurosci Res. 2021. Vol. 99, N 12. P. 3274–3283. doi: 10.1002/jnr.24958

[27] Sabinina TS, Bagaev VG, Alekseev IF. Prospects for applying xenon curative properties in pediatrics. Pediatric Pharmacology. 2018;15(5):390–395. EDN: VBURNO doi: 10.15690/pf.v15i5.1961

[28] Сабинина Т.С., Багаев В.Г., Алексеев И.Ф. Перспективы применения лечебных свойств ксенона в педиатрии // Педиатрическая фармакология. 2018. Т. 15, № 5. С. 390–395. EDN: VBURNO doi: 10.15690/pf.v15i5.1961

RIGHTS & PERMISSIONS

Eco-Vector