The pharmacological profilaxis of perioperative seizures is not yet standardized: many protocols suggest the use of phenytoin (PHT), in oral administration at a mean dosage of 300 mg/ day (4-5 mg/Kg/day). This drug, for its peculiar kinetic (nonlinear pharmacokinetics, long and variable half-life, long time to reach the steady-state) is not, at least theorically, suitable for a short-term prevention. In order to compare the oral and parenteral route of administration of PHT and to standardize a efficient and safe protocol of profilaxis we administered in 10 patients undergoing nerosurgery for a sovratentorial disease an oral load of PHT (500 mg/day in 5 fractionated doses 4 days before intervention) and in 10 patients an intravenous load the day before the intervention (15 mg/Kg in three fractionated doses in 6 hours), followed by a dose of 15 mg/Kg every 24 hours. Serial determination of plasma levels of PHT were obtained for all patients. In most of them we were able to obtain a tissue level of the drug (from biopsy in the perilesional area). We present the clinical and pharmacological results of the study.
|Number of pages||1|
|Journal||Italian Journal of Neurological Sciences|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Clinical Neurology