Acta Neurochirurgica

, Volume 84, Issue 1–2, pp 36–38

Phenytoin plasma levels after intraoperative administration, for the prevention of post-craniotomy seizures

  • M. Tsolaki
  • M. Yannacou-Peftoulidou
  • Ph. Grammaticos
  • E. Sofianos
  • G. Foroglou
Article

Summary

Since in a previous study (preliminary report) (18) the iv. administration of 15 mg × kg−1 of phenytoin (PNT) over 30 min in men produced toxic levels (25μg/ml), a smallerr iv. dose of 7 mg×kg−1 was given during anaesthesia to 80 patients under going craniotomy, for the prevention of post-operative seizures.

Plasma PNT concentrations were studied in 22 patients before its iv. infusion 20min, 40min, and 1, 2, 3, 5, 8 and 12 hours later.

Mean serum phenytoin levels were 9.3,31.9,27.8,25.5,19.4,17.2, 15.4 and 19.2* μg/ml respectively.

In this study it appeared that although the initial dose was 50% smaller than before, toxic levels were still encountered one hour after PNT administration (therapeutic range 10–25 μg/ml). Bearing in mind that in both our studies PNT appeared to have approximately the same efficacy in seizure prevention (from 95–97%), we suggest, that 7–10mg × kg−1 would be adequate if administered as an intraoperative iv. infusion over an hour and that whenever possible serial serum levels should be monitored.

Keywords

phenytoin craniotomy post-operative seizures 

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Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • M. Tsolaki
    • 1
  • M. Yannacou-Peftoulidou
    • 1
  • Ph. Grammaticos
    • 2
  • E. Sofianos
    • 1
  • G. Foroglou
    • 3
  1. 1.Department of AnaesthesiologyAhepa HospitalThessalonikiGreece
  2. 2.Department of Nuclear MedicineAhepa HospitalThessalonikiGreece
  3. 3.Department of Neurological Surgery, Ahepa HospitalSurgical Clinic of the UniversityThessalonikiGreece

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