Thiopental Efficacy in Phenobarbital-Resistant Neonatal
Seizures

Bonati, Maurizio; Marraro, Giuseppe A.; Celardo, Antonio; Passerini, Francesco; Schieroni, F.; Spada, Pablo; Valsecchi, Roberto; Capitani, E De

doi:10.1159/000457614

Cited by 22 publications

(9 citation statements)

References 13 publications

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“…A total of 11 additional studies meeting inclusion criteria, but without comparison groups, were placed into Tier II (Table 2). [21][22][23][24][25][26][27][28][29][30][31] Of the Tier I investigations, Painter et al's study 8 was the only one to focus on phenobarbital and phenytoin. The wellconstructed trial randomized 59 patients to receive phenobarbital to a goal free level of 25 mg/mL or phenytoin to a free level of 3 mg/mL, with crossover to the alternate therapy if the first failed.…”

Section: Resultsmentioning

confidence: 99%

Pharmacological Treatment of Neonatal Seizures

2013

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Pharmacologic treatment options for neonatal seizures have expanded over the last two decades and there is no consensus on optimal treatment strategy. We systematically reviewed the published literature to determine which medication(s) are most effective for treating neonatal seizures, by retrieving trials and observational investigations via PubMed (through August 2011) that focused on pharmacological seizure treatment of neonates (≤ 28 days old) and utilized continuous or amplitude-integrated EEG to confirm seizure diagnosis and cessation. Our search identified 557 initial articles and 14 additional studies after reference reviews, with 16 meeting inclusion criteria. Two were randomized trials and only three additional investigations included comparison groups. We found limited evidence regarding the best pharmacologic treatment for neonatal seizures, but were able to devise a treatment algorithm from available data. These findings have the potential to serve both as a clinical reference and inform the design of comparative effectiveness investigations for neonatal antiepileptics.

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Section: Resultsmentioning

confidence: 99%

Pharmacological Treatment of Neonatal Seizures

2013

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“…They administered highdose thiopental (10 mg/kg IV) in nine severely asphyxiated neonates (body weight: 1,120-3,750 g; GA: 33-41 weeks) and observed mild hypotension and EEG suppression. 4 Other reports concerning thiopental administration in neonates and children (loading dose: 10-15 mg/kg; maintenance infusion: 0.75-5 mg/kg/hour) indicated no major side effects such as severe hypotension. Although the total thiopental dose (1-3 mg/kg/hour over 3 days) administered was low, as shown in ►Figs.…”

Section: Discussionmentioning

confidence: 98%

“…2A, amplitude-integrated electroencephalogram (aEEG) recording after maintenance thiopental infusion showed the suppression of electrical activity, as previously described. 4 On day 7, electrical activity improved (►Fig. 2B).…”

Section: Case Reportmentioning

confidence: 98%

Early Postnatal Seizures in a Neonate with Wolf–Hirschhorn Syndrome

Haneda

Maeda

et al. 2016

AJP Rep

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Background Wolf–Hirschhorn syndrome (WHS), which is characterized by a typical facial appearance, growth retardation, mental retardation, seizures, and congenital cardiac defects, has an estimated incidence of 1 per 50,000 births. Case We report a case of a low birth weight neonate with WHS and seizures, as well as persistent pulmonary hypertension in the early neonatal period. Apgar scores were 6 (1 minute) and 8 (5 minutes) with evident retraction. After admission to the neonatal intensive care unit, the patient had tonic–clonic seizures with epilepticus 30 minute after birth. Although the seizures were uncontrollable, continuous thiopental administration was effective for seizure mitigation. Conclusion Neonatal seizures with WHS occur rarely. This is the first case report on seizures just after birth in a neonate with WHS.

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“…Die terminale Eliminationshalbwertszeit nach einer Bolusdosis wird für Thiopental bei Neu-und Frühgeborenen sehr unterschiedlich mit Zeiten zwischen 9-17,9 h angegeben; dies ist deutlich länger als bei größeren Kindern [6,52,64]. Die Wirkdauer von Benzodiazepinen ist ebenfalls verlängert.…”

Section: Intravenöse Anästhetikaunclassified

Anästhesiologische Aspekte in der Neu- und Frühgeborenenchirurgie

Breschan¹,

Likar²

2006

Anaesthesist

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The physiology of the preterm and term neonate is characterized by a high metabolic rate, limited pulmonary, cardiac and thermoregulatory reserve and decreased renal function. Multisystem immaturity creates important developmental differences in drug administration and response when compared to older children. Specific monitoring techniques are required because the neonate is not physically accessible to the anesthetist during the operation. This contribution reviews the specific pathophysiological characteristics of the newborn with relevance to anesthesia and also provides robust guidelines for the anesthetic management of the most frequent non-cardiac procedures which need surgery during the neonatal period. Consideration will also be given to the anesthetic management of very low birth-weight infants with anesthetic key issues such as avoiding hyperoxia, keeping hemodynamic parameters as stable as possible and preventing hypothermia.

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Thiopental Efficacy in Phenobarbital-Resistant Neonatal Seizures

Cited by 22 publications

References 13 publications

Pharmacological Treatment of Neonatal Seizures

Pharmacological Treatment of Neonatal Seizures

Early Postnatal Seizures in a Neonate with Wolf–Hirschhorn Syndrome

Anästhesiologische Aspekte in der Neu- und Frühgeborenenchirurgie

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