Alternatives to XXXX in the Wada test.

@entity4485 @entity1 @entity410 @entity1875 @entity4671 @entity1576 @entity20611 @entity3694
OBJECTIVE: To review the literature and identify alternatives to @entity20611 for use in the Wada test. DATA SOURCES: A search of PubMed (1960-October 2010) was performed using the following key words alone or in combination: Wada test, intracarotid amobarbital procedure, intracarotid, intraarterial, @entity20611 , @entity3694 , Brevital, @entity4485 , @entity4671 , @entity1875 , and alternative anesthetics. References of the identified articles were reviewed for relevant information. STUDY SELECTION AND DATA EXTRACTION: All articles in English identified from the data sources were evaluated. Review included comparative, prospective, and retrospective studies along with case series and case reports. DATA SYNTHESIS: @entity3694 , @entity4485 , @entity4671 , and @entity1875 have all been studied as alternatives to @entity20611 in the Wada test. Four controlled experimental trials, 1 uncontrolled experimental trial, 6 retrospective chart reviews, and 2 case reports were reviewed. @entity3694 , @entity4485 , and @entity1875 required a second injection due to their short duration of action. @entity4671 was studied as a bolus injection followed by a continuous infusion until the critical speech and memory tests were administered, which differed from the standard Wada test procedure. @entity1 had an increased risk of @entity410 with @entity3694 , whereas 1 @entity1 developed transient @entity1576 immediately after receiving @entity4485 . Furthermore, @entity1875 caused increased tone with twitching and rhythmic movements, which interfered with the completion of the Wada test for 1 @entity1 . All authors concluded that these agents were equivalent to amobarbital for the Wada test. CONCLUSIONS: @entity3694 , @entity4485 , @entity4671 , and @entity1875 are viable alternatives to @entity20611 for use in the Wada test, but each has shortcomings.
