The Preventional Function Of Routine Usage Of Perioperative Brain Antiepileptic Drug Valproate To Epilepsy After Surgery

Objective: To evaluate perioperative neurosurgical routineapplication of sodium valproate on the prevention of postoperativeepilepsy. Methods: A prospective randomized study, choose239casesfrom our department in May2009-2010May craniotomy including threetypes of patients as brain trauma, brain tumors and cerebrovasculardisease. Cases inclusion criteria are as follows:①M ay2009-2010Mayin our department in patients undergoing craniotomy;②three diseasetypes of brain trauma, brain tumors and cerebrovascular disease③noliver and kidney disease, progressive ordegenerative diseases. Exclusioncriteria are as follows:①pregnant and lactating women;②withprevious history of seizures taking antiepileptic drugs;③family historyof epilepsy.Standard. Cases of239patients chosen, of which the oldest75years old, the minimum in June, an average of38.5years.117cases ofmale and female122cases.115cases of traumatic brain injury, includingmild head injury in20cases (17.4%), moderate traumatic brain injury in28cases (24.3%),67patients with severe head injury (58.2%).45cases ofintracranial tumors, including21cases of meningioma (46.7%), glioma in24patients (53.3%).79cases of cerebral vascular disease, including48cases of hypertensive intracerebral hemorrhage (60.8%) aneurysms in21 cases (26.6%), arteriovenous malformation in10cases (12.7%).Will bebased on three categories of patients randomly were divided intopreventive group and the control group of122cases117cases, of which60cases of brain injury prevention group,23cases of intracranial tumors,cerebrovascular disease in39cases,55cases of head injury control group,intracranial tumors in22cases,40cases of cerebrovascular disease. Thetreatment options are: brain trauma, cerebral hemorrhage and someaneurysm patients to emergency surgery. Control group before and aftersurgery to give only the conventional therapy, including: bleeding, fluidreplacement, dehydration, reduce intracranial pressure, anti-inflammatory,nutritional, and other symptomatic treatment, in the absence of the formerseizures without antiepileptic drugs, seizures occurred in patientsgivensodium valproate antiepileptic therapy or switch to otherantiepileptic drugs. Prevention group were treated on the basis ofemergency surgery to give patients before VPA15mg/Kg dissolved in100ml1h intravenous infusion of normal saline,1h completed within thedroplets. Elective surgery and the period from the date of hospitalizationor surgery the first3days of oral sodium valproate15mg/Kg, surgicalprocedures, to the intravenous infusion of valproate15mg/Kg, dropsbefore the end of surgery done, after giving valproatesodium dissolved in100ml normal saline intravenously5mg/Kg,1h completed within thedroplet, used once every8h, continuously in3days,3days stopped intravenous drug use,3day oral administration of sodium valproate15mg/Kg, continued to take3months. Efficacy and side effects wereobserved and analyzed after the occurrence of epilepsy and diseases,surgical injury, intracranial hemorrhage, brain edema and sodiumvalproate serum concentration relationship. Observation methods:Patients hospitalized reactions observed during the day after discharge,both for outpatient and telephone follow-up, patients with suspectedseizures routine EEG to appear spikes, sharp waves or spike and wave asthe diagnostic criteria, and record the seizure type and frequency, seizuretype to the first subject, and the review of head CT, and liver and kidneyfunction, blood, the clotting time.Clinical data of these patients by use ofsodium valproate spss17.0software to analyze whether the incidence ofepilepsy after an impact. Results: Patients with head injury preventiongroup class60cases of epilepsy in1case,1.7%incidence of epilepsy,control group55cases,7cases of epilepsy, seizures, incidence of12.7%,P <0.05; brain-tumor group of23patients to preventepilepsy patients withno control group,22cases,5cases of epilepsy, seizures, incidence of22.7%, P <0.05; prevention of cerebrovascular disease in patients withtype39cases,1case of epilepsy, epilepsy incidence of2.6%, controlgroup,40cases,8cases of epilepsy, seizures, incidence of20.0%, P<0.05.CONCLUSION: Sodium valproate in the prevention ofneurological surgery can significantly reduce the application of brain injury category, type of brain tumors and cerebrovascular diseasecategories the incidence of epilepsy patients, and fewer adversereactions..