The need for valproic acid as prophylaxis in neurosurgery patients | [Pakistan Journal of Pharmaceutical Sciences • 2023]

Author(s):

1. Shaharyar Sheikh: Department of Neurosurgery, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, Pakistan; Department of Neurosurgery, Central Park Teaching Hospital, Lahore, Pakistan

2. Kamran Hussain: Department of Neurosurgery, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, Pakistan; Department of Neurosurgery, Central Park Teaching Hospital, Lahore, Pakistan

3. Saman Shahid: Department of Sciences & Humanities, National University of Computer & Emerging Sciences (NUCES),Lahore,Pakistan

4. Rana Aatif Siddique: Department of General Medicine and Gastroenterology, Shahida Islam Medical and Dental College,Lodhran,Pakistan

5. Mehreen Kamran: Department of Medicine, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital,Lahore,Pakistan

Abstract:

Using anti-epileptic drugs in neurosurgery patients is a routine practice. This controlled trial aimed to assess whether prophylaxis with Valproate in brain surgery patients is justified or not. Group A (n=50; controls) patients received valproic acid postoperatively for three months, while group B (n=50; subjects) received a placebo. Serum valproic acid levels between 50-125g/ml were required. Kendall's Tau was applied to see the correlation between the 'frequency of seizures' between different surgical procedures performed and the extent of manipulations-EOMs. A wireless EMOTIV EPOC device was used to visualize the Electroencephalogram patterns. In controls, 12 patients had one seizure and only two patients had 2 seizures. In the placebo group, 13 patients had one and 4 patients had 2 seizures. The seizure frequency was highest amongst brain tumor patients. An insignificant difference was found between the seizure frequencies of the placebo and control groups. A statistically insignificant correlation was found between seizure frequency and independent variables: surgical procedures and EOM (%). Using an AED or not, the frequency of seizures did not substantially reduce over the postoperative period. If not necessary, the anti-epileptic medication that is frequently provided as a prophylactic against seizures in the post-operative period should not be administered.

Page(s): 1783-1792

DOI: 10.36721/PJPS.2023.36.6.REG.1783-1792.1

Published: Journal: Pakistan Journal of Pharmaceutical Sciences, Volume: 36, Issue: 6, Year: 2023

Keywords:

Prophylaxis , Seizures , hydrocephalus , Trauma , Brain Tumors , Antiepileptic drugs AEDs

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