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Show 210 Myriam Delgado BACKGROUND Status epilepticus (SE) is defined as 30 min of continuous seizure activity or 2 or more sei-zures during this time period without full recovery of consciousness (1). The first line therapy for SE includes the use of benzodiazepines. Both clinical and animal studies indicate that af-ter 30-60 min, SE becomes refractory to treatment with benzodiazepines, and thus is associ-ated with significant mortality and morbidity (2, 3). Treatments for benzodiazepine-resistant SE include the use of anti-epileptic drugs, barbiturates and anesthetics (4). Using the lithi-um- pilocarpine model of SE, we compared the effectiveness of pentobarbital and propofol in terminating diazepam-resistant SE. METHODS Male, Sprague Dawley rats implanted for electroencephalogram (EEG) recordings were pretreated 18-24 h before pilocarpine treatment with lithium chloride (127 mg/kg). Sco-polamine bromide (1 mg/kg) was administered 30 min prior to the injection of pilocarpine (50 mg/kg). At various time points after the development of the first motor seizure, either vehicle, diazepam (10 mg/kg), pentobarbital (30 mg/kg) or propofol (100 mg/kg) was injected intraperitoneal. Video-EEG data were collected for 24 h. The EEG data from 0-10 h after the administration of the test drug was band-pass filtered (20-70 Hz) and the power spectral density calculated and plotted over time. To compare across groups, the energy data were fit with an 8th order polynomial and statistical analyses were performed at different times after onset of SE. RESULTS When administered at 60 min after the first motor seizure, diazepam was consistently ineffec-tive at suppressing SE (n=12) and similar to vehicle (n=15). In contrast, both propofol (n=15) and pentobarbital (n=15), when given at 60 min, greatly reduced the mean power of the EEG. The effect was often detectable within 30 min, and was usually maximal at 2 h after adminis-tration. CONCLUSION At a time point when treatment with diazepam was ineffective in terminating SE, both propofol and pentobarbital were efficacious. Therefore, these animal data provide further evidence for the use of propofol and pentobarbital for the treatment of benzodiazepine-resistant SE. THE EFFICACY OF PROPOFOL AND PENTOBARBITAL IN THE TREATMENT OF PILOCARPINE-INDUCED, BENZODIAZEPINE-RESISTANT STATUS EPILEPTICUS Myriam Delgado (F. Edward Dudek) Department of Physiology University of Utah School of Medicine Health sciences leap program spring 2012 F. Edward Dudek |