Seizure attack during partial hepatectomy in a living donor for liver transplantation under sevoflurane anesthesia

We report a case of generalized convulsion during partial hepatectomy for the purpose of organ donation for syngenesioplastic liver transplantation under sevoflurane anesthesia. This 23-year-old male Taiwanese living donor had no history of epilepsy. Anesthesia was inducted with fentanyl, propofol and rocuronium was used to facilitate endotracheal intubation. Sevoflurane in the mixture of oxygen and air and rocuronium were used for maintenance of anesthesia. Generalized convulsion with mild fever was observed 11 hours after the start of surgery when the surgeons happened to take a recess pending the removal of the recipient's liver. Convulsive episode subsided after aggressive management. Another 3 hours were required to complete the operation and the patient woke up in the postanesthesia room uneventfully.