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백선하,왕규창,오창완,정천기,김동규,정희원,김현집,조병규,최길수,한대희 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.7
Diphenylhydantoin(DPH) has been used intravenously as a drug of choice in conditions which seizure patients are incapable of oral Teeding or in a state of status epilepticus However, its clinical use has limitations because of its serious side effects o# cardiac depression or systemic hypotension In Western countries. the recently do- veloped intravenous sodium valproate has been reported as safe and e#Tective for seizure control in such patients To assess the safety and effectiveness in seizure control we investigated the serum levels of the drug at f4 hours 48 hours and 7 days after intravenous administration of sodium valproate(Depakine른. occurrence of seizures in the perioperative period and the side eT#ects of the drugs in 30 neurosurgical patients older than 3 years of age The mean serum concentrations of valproic acid after bolus injection To IS mg/kg followed by continuous infusion with the rate To OSmg/kg/hour, were over 450 rg/ml . 좌S 0± IS 3 ff/ml at 운4 hours, 504±fl 0 f(g/ml at 좌』 hours and 58 9±tO 7 賠,/1 at 7 days aTter the sta「t of the adinistration All the Patients whose se「u vaIProic acid levelwas witHin the therapeutic range(40-100 rr/ml). had never experienced an episode of seizure attack during the perioperative days There was no evidence of elevated liver enzyme activity, but there were evidence of some tendencyof decreased platelet count in the peripheral blood at f days a#ter the administration of intravenous Yalproic acid Four patients experienced episodes of mild nausea and/or vomiting in conclusion per'ioperat'ive intravenous administration of valproic acids in neurosurgical patients was safe and effective in seizure control However it must be used precauciously in the patients with compromized coagulation system