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ILAE International Survey on Anesthetic Use in Status Epilepticus in Adults

ILAE International Survey on Anesthetic Use in Status Epilepticus in Adults: A Global Practice Assessment from the Emergency Treatment Task Force.

Introduction
Status epilepticus (SE) is a life-threatening neurological emergency with significant variability in clinical management and national guidelines. The use of anesthetics in adult (≥16 years old) refractory SE varies considerably across centers worldwide, both in terms of timing, duration, and drug selection. This survey aims to assess current practices regarding anesthetic administration in SE across different healthcare settings globally, to identify areas where international recommendations or guidelines may be needed.
SECTION A: CENTER DEMOGRAPHICS
1.In which country is your center located?(Required.)
2.What type of institution is your center?(Required.)
3.What is the estimated number of SE cases managed at your center per year?(Required.)
4.Does your center have a written protocol for SE management?(Required.)
SECTION B: PREHOSPITAL MANAGEMENT
5.In your prehospital emergency system, which benzodiazepines are used for SE?(Required.)
6.In your prehospital emergency system, what are the usual routes of administration for benzodiazepines? (Select all that apply)(Required.)
7.In your prehospital emergency system, which medications are available in the ambulance and used for SE? (Select all that apply)(Required.)
8.Are there standardized protocols for SE treatment in your prehospital emergency services?(Required.)
9.Is intravenous anesthetic administration ever performed in the prehospital setting?(Required.)
SECTION C: IN-HOSPITAL FIRST AND SECOND-LINE TREATMENT
10.Which benzodiazepine is preferred as first-line intravenous treatment for SE at your center?(Required.)
11.Which antiseizure medication is most commonly used as intravenous second-line treatment?(Required.)
SECTION D: ANESTHETIC USE IN REFRACTORY SE
12.Which anesthetic is most commonly used as intravenous third-line treatment for refractory SE at your center? (Select all that apply)(Required.)
13.In which clinical scenarios do you administer anesthetics earlier than third-line (i.e., as second-line treatment after the failure of benzodiazepines)?(Required.)
14.What is the typical timing of anesthetic administration at your center?(Required.)
15.At your center, based on the estimated duration of status epilepticus, when are anesthetic agents typically initiated?(Required.)
16.Which anesthetic do you prefer for early induction (i.e. after failure of first line Benzodiazepines) if applicable?(Required.)
SECTION E: IMAGING AND EEG MONITORING AND TARGETS
17.Do you usually perform brain imaging for diagnostic purposes and during SE?(Required.)
18.Is continuous EEG monitoring routinely available at your center for SE management?
19.Which EEG target do you use during anesthetic infusion?
20.What is the average duration of anesthetic infusion at your center?
SECTION F: COMPLICATIONS AND CONCERNS
21.Which complications do you most fear with anesthetic use in SE? (Select all that apply)
22.What are the main barriers to early anesthetic use at your center? (Select all that apply)
SECTION G: NEED FOR GUIDELINES
23.Do you believe there is a need for more detailed international guidelines on anesthetic use in SE?
24.Which aspects of anesthetic use in SE would benefit most from clearer guidelines? (Select all that apply)
25.Any additional comments or suggestions regarding anesthetic management in SE?