• Mae Zhang, Rory Vu Mather, Ashley R Chung, Chee Fai Andy Leung, Radhamangalam J Ramamurthi, and Patrick L Purdon.
• From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.
• A A Pract. 2025 Jan 1; 19 (1): e01910e01910.

AbstractIn this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%. This highlights the potential impact of astrocyte dysfunction on anesthetic sensitivity and robustness of EEG as a biomarker of anesthetic effect, including for pediatric patients with rare neurodevelopmental diseases.Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Anesthesia Research Society.

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