Prevention of perioperative seizures in neurosurgery: Proposal of a protocol with phenytoin i.v. and comparison with oral administration

E. Montaienti, P. Ferroli, M. Bonzanino, B. Massa Micon, L. Moscato, F. Benech, P. Benna

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)125
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume18
Issue number4
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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