Introduction
Hard prerequisite for every agent below: a secured airway + mechanical ventilation + continuous EEG + ICU, with vasopressors immediately available. These are anesthetic doses far higher than ICU sedation; they cause apnea and hypotension. Adult dosing only (not validated for pediatrics); not for post-arrest myoclonic status or epilepsia partialis continua. Teaches the approach, use your institution's SE order set.
Before you call it refractory: confirm adequate first-line benzodiazepine dosing (lorazepam 0.1 mg/kg IV, max 4 mg/dose, repeat once; or IM midazolam 10 mg if >40 kg, 5 mg if 13–40 kg when no IV). Under-dosed benzodiazepines are common and may contribute to pseudo-refractory SE.
Case Presentation
- A 62-year-old is in generalized convulsive status epilepticus.
- She received lorazepam 4 mg IV ×2 and levetiracetam 60 mg/kg, but is still seizing at 30 minutes on cEEG.
- This is refractory status epilepticus (RSE). She is intubated and ventilated.
- Which continuous IV anesthetic drip, and at what dose?
- No single agent is proven best, choose by hemodynamics, PRIS risk, and titration to cEEG.
Clinical Detail
Pharmacology: The Four RSE Anesthetic Infusions
Units switch: boluses are mg/kg; propofol infusion is mcg/kg/min; midazolam, ketamine, and pentobarbital infusions are mg/kg/h. Do not carry a unit across. Dose on your institution's specified weight (IBW/adjusted for propofol and ketamine in obesity).
| Drug | Loading bolus | Maintenance infusion (titrate to cEEG) | Re-bolus | Key adverse effects / monitoring | Role / notes |
|---|---|---|---|---|---|
| Midazolam (GABA) | 0.2 mg/kg IV | 0.05–2 mg/kg/h (start ~0.2); max 2 mg/kg/h | 0.1 mg/kg before each increase | Hypotension (less than propofol/pento); tachyphylaxis (rising rate is expected, not failure); active metabolite accumulates in renal failure (delayed awakening; wean earlier/slower) | Common first CIVAD; hemodynamically gentler. Target seizure cessation |
| Propofol (GABA) | 1–2 mg/kg IV, pushed slowly by an authorized provider; vasopressor ready first | 50 mcg/kg/min, titrate by 10; operational ceiling ~100 (up to 200 for burst suppression is physician-directed with explicit PRIS caution) | Optional / physician-directed; rate can rise without a routine bolus | PRIS: metabolic acidosis/lactate, rhabdomyolysis (CK), hypertriglyceridemia, hyperkalemia, AKI, cardiac failure, arrhythmias, Brugada-type ST (not QTc). Risk = dose × duration (>48 h) × catecholamines/steroids. Lipid emulsion 1.1 kcal/mL (count calories, check triglycerides); dedicated line. Hypotension (usually needs a pressor) | First-line CIVAD, esp. hemodynamically stable and/or renal failure; if sustained high-dose >48 h, plan to switch |
| Ketamine (NMDA) | 1 mg/kg IV | 0.5 mg/kg/h, titrate by 0.5; max ~7.5 mg/kg/h (some protocols to 10) | 1 mg/kg with each change | Usually hemodynamically neutral-to-favorable, but a direct myocardial depressant that can drop pressure once catecholamine reserve is exhausted. Emergence reactions (mitigate with a benzodiazepine). Avoid in uncontrolled hypertension or intracranial hypertension (the older ICP concern is now considered overstated in ventilated/sedated patients) | Added when GABA agents stall or BP will not tolerate more; growing interest in earlier use as GABA-A receptors internalize and NMDA up-regulate over time |
| Pentobarbital (barbiturate) | 10 mg/kg IV given SLOWLY (e.g. ≤25–50 mg/min), vasopressors + volume ready first | 0.5–5 mg/kg/h (NCS 2012; some protocols cap 4), titrate by 0.5 to burst suppression | 5 mg/kg for breakthrough seizures | Profound dose-dependent hypotension (needs vasopressors); ileus, immunosuppression; very long context-sensitive half-life. Hepatic enzyme inducer (phenytoin/valproate interactions variable or bidirectional, monitor levels). Alkaline (pH ~9.5) → dedicated line, verify Y-site incompatibility. Serum level 20–40 mcg/mL if obtained | Last resort (super-refractory); Neurology + critical-care JOINT decision. Target burst suppression |
Sequence, Targets & Safety
| Parameter | Detail |
|---|---|
| SE definition |
|
| Stepwise sequence |
|
| cEEG target |
|
| The bolus rule |
|
| Hemodynamics |
|
| Preparation / lines |
|
| Weaning |
|
Evidence
Overview of Evidence
| Author, year | Design / N | Focus | Key point |
|---|---|---|---|
| Vossler, 2025 | Narrative review (Continuum) | First seizures, ARS, SE | For nonanoxic convulsive RSE, equipoise between adding a second nonsedating ASM vs starting an anesthetic CIVAD |
| Au, 2024 | Systematic review, 66 studies, N=1637 (JAMA Neurology) | Comparing initial CIVAD in RSE | Differences in short-term failure, hypotension, substitution; NO clear optimal agent; non-epilepsy RSE higher substitution (50% vs 26%) and mortality (43% vs 11%). A seizure- vs burst-suppression signal (OR 7.72) is noncausal and imprecise |
| Kapur (ESETT), 2019 | Blinded RCT, N=384 (NEJM) | LEV vs fosphenytoin vs valproate for benzo-refractory established SE | ~45–47% reached the 60-min composite (no clinical seizures + improved responsiveness, no added med); no significant difference, the basis for the interchangeable step-2 options |
| Almohaish, 2024 | Review (Semin Neurol) | SE pharmacological management | Confirms the staged approach; midazolam, propofol, pentobarbital, ketamine are the RSE infusions; most efficacious not defined |
| Brophy (NCS), 2012 | Consensus practice guideline (Neurocrit Care) | Evaluation + management of SE | Foundational weight-based CIVAD dosing; bolus before infusion |
Conclusions
- Refractory SE (still seizing after an adequately-dosed benzodiazepine + one urgent-control ASM): for generalized convulsive RSE, intubate, start cEEG, and begin a continuous IV anesthetic infusion while optimizing maintenance ASMs (trying a further nonsedating ASM first is more for focal RSE or NCSE without coma).
- Four agents, no proven winner (JAMA Neurology 2024, 66 studies): midazolam and propofol are typical first CIVADs, ketamine is added when GABA agents stall or the blood pressure will not tolerate more, pentobarbital is the last resort (joint Neuro + critical-care decision).
- Dose to the blood pressure: propofol and pentobarbital drop it (have pressors ready before the bolus); midazolam less; ketamine is usually neutral but can fail once catecholamine reserve is gone. Avoid ketamine in uncontrolled hypertension or intracranial hypertension.
- Bolus before starting midazolam or ketamine and before each of their increases (propofol can up-titrate without one; pentobarbital 5 mg/kg is for breakthrough); use your institution's dosing weight (IBW/adjusted for propofol/ketamine in obesity); RSE dosing is far higher than ICU sedation. Watch propofol for PRIS (acidosis/lactate, CK, triglycerides, Brugada-type ECG), especially sustained high dose beyond 48 h.
- Wean one agent at a time in reverse order after 24–48 h of seizure freedom, keep scheduled ASMs on board, and restart midazolam before weaning pentobarbital.
References
- Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3-23. PMID: 22528274
- Au YK, Kananeh MF, Rahangdale R, et al. Treatment of Refractory Status Epilepticus With Continuous Intravenous Anesthetic Drugs: A Systematic Review. JAMA Neurol. 2024;81(5):534-548. PMID: 38466294
- Kapur J, Elm J, Chamberlain JM, et al. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus (ESETT). N Engl J Med. 2019;381(22):2103-2113. PMID: 31774955
- Almohaish S, Tesoro EP, Brophy GM. Status Epilepticus: An Update on Pharmacological Management. Semin Neurol. 2024;44(3):324-332. PMID: 38580318
- Vossler DG. First Seizures, Acute Repetitive Seizures, and Status Epilepticus. Continuum (Minneap Minn). 2025;31(1):95-124. PMID: 39899098
- Wiss AL, Samarin M, Marler J, Jones GM. Continuous Infusion Antiepileptic Medications for Refractory Status Epilepticus: A Review for Nurses. Crit Care Nurs Q. 2017;40(1):67-85. PMID: 27893511
Tags:Status Epilepticus
Anesthetic Infusions
Neurocritical Care
Neurology
Never Miss a Friday Pearl
Get Pharmacy Pearls in your inbox every Friday
Free weekly clinical pearls written for pharmacists. Practical, evidence-based, and built for bedside use.
Free forever. Unsubscribe anytime. No spam, ever.