Propofol as a substitute for amobarbital in Wada testing.

Albert Ho Yuen Chiu, Michael Bynevelt, Nicholas Lawn, Gabriel Lee, Tejinder Pal Singh

Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2016;22(11):1830-2

PMID: 26188665

Full Text on Elsevier Science View on PubMed

Abstract

We describe a patient with equivocal findings on functional MRI (fMRI), who underwent a propofol Wada test, review the literature on this topic and suggest a protocol for the use of propofol for a Wada test. Although fMRI techniques can usually accurately lateralize language, the Wada test remains the gold standard for preoperative lateralization and is occasionally still required if there are non-diagnostic findings on fMRI. Amobarbital, the agent of choice for the Wada test, has become increasingly difficult to obtain and requires regulatory approval, which may delay definitive management and have an impact on patient outcomes. Propofol has been suggested as an alternative to amobarbital, and while there is some published data on this, there is no reported Australian experience to date.

Address: Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Neurological Intervention and Imaging Service of Western Australia, Royal Perth Hospital, Perth, WA, Australia. Electronic address: [email protected].; Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; Neurological Intervention and Imaging Service of Western Australia, Royal Perth Hospital, Perth, WA, Australia.; Department of Neurology, Royal Perth Hospital, Perth, WA, Australia.; Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, WA, Australia.

DOI: 10.1016/j.jocn.2015.04.014

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MeSH Terms: Amobarbital, Australia, Brain Neoplasms, Craniotomy, Electroencephalography, Female, Humans, Hypnotics and Sedatives, Intraoperative Neurophysiological Monitoring, Language Tests, Magnetic Resonance Imaging, Neuronavigation, Propofol, Wakefulness, Young Adult