Epilepsy Surgery

Epilepsy surgery • Hx → type generalized, focal, absence, with, or without Aura • Review all meds, mainly anticonvulsant → ↑ metabolism of NDMR • Discuss with the surgeon the anesthetic plan GA Vs sedation with LA • May need awake test with speech mapping • In case of sedation use a judicious amount of sedation, O2 by NP, and keep communication with Pt all the time • In case of A/W obstruction D/C sedation gtt, 100% O2→ LMA, ETT • In addition to the standard CAS monitoring, if an Art-line needed have in the same side of the lesion e.g. Rt temporal Rt radial art line • Avoid any pre-med that may change the seizure threshold, also avoid any long acting anticonvulsant