Rationale for giving antiepileptics intraoperatively in patients undergoing surgery for supratentorial brain tumors.
- 1Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
- 2Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
- 3Department of Neuroanaesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
Background
Early postoperative seizures remain a frequent complication in supratentorial tumor surgery. There is no standard recommendation for additional intraoperative phenytoin administration.Methods
One hundred patients with supratentorial brain tumors undergoing surgery were included. All patients received regular phenytoin preoperatively and received an additional dose of phenytoin intraoperatively. Phenytoin levels were measured in preoperative, intraoperative, and postoperative periods. Presence or absence of seizures in the postoperative period was recorded.Results
The mean preoperative phenytoin values were 15.9 ± 2.623, intraoperative phenytoin levels were 11.38 ± 3.667, and the mean postoperative phenytoin levels were 14.03 ± 2.607. Eight patients developed seizures in the postoperative period. The mean difference between intraoperative and postoperative drug levels was significant in the seizure group as compared to the other group.Conclusion
Intraoperative phenytoin levels dropped in all patients during surgery, but the drop was significantly higher in patients who developed seizures in the postoperative period. The routine measurement of perioperative plasma phenytoin levels may be associated with the use of adding phenytoin intraoperatively to reduce the incidence of postoperative seizures. The aim of our study was to determine the plasma phenytoin levels in intraoperative period which can determine early postoperative seizure risk.
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BibTeX
@article{singh2026rationale,
title = {{Rationale for giving antiepileptics intraoperatively in patients undergoing surgery for supratentorial brain tumors.}},
author = {Apinderpreet Singh and Hanuma Naik Banavath and Sandeep Mohindra and Bansil Vrujlal Javia and Hemant Bhagat and Anju Bansal and Sunil Kumar Gupta},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_140_2026},
url = {https://europepmc.org/article/MED/42974533},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Rationale for giving antiepileptics intraoperatively in patients undergoing surgery for supratentorial brain tumors.
AU - Apinderpreet Singh
AU - Hanuma Naik Banavath
AU - Sandeep Mohindra
AU - Bansil Vrujlal Javia
AU - Hemant Bhagat
AU - Anju Bansal
AU - Sunil Kumar Gupta
PY - 2026
DA - 2026/10/23
JO - Surgical neurology international
DO - 10.25259/sni_140_2026
UR - https://europepmc.org/article/MED/42974533
AB - Background Early postoperative seizures remain a frequent complication in supratentorial tumor surgery. There is no standard recommendation for additional intraoperative phenytoin administration.Methods One hundred patients with supratentorial brain tumors undergoing surgery were included. All patients received regular phenytoin preoperatively and received an additional dose of phenytoin intraoperatively. Phenytoin levels were measured in preoperative, intraoperative, and postoperative periods. Presence or absence of seizures in the postoperative period was recorded.Results The mean preoperative phenytoin values were 15.9 ± 2.623, intraoperative phenytoin levels were 11.38 ± 3.667, and the mean postoperative phenytoin levels were 14.03 ± 2.607. Eight patients developed seizures in the postoperative period. The mean difference between intraoperative and postoperative drug levels was significant in the seizure group as compared to the other group.Conclusion Intraoperative phenytoin levels dropped in all patients during surgery, but the drop was significantly higher in patients who developed seizures in the postoperative period. The routine measurement of perioperative plasma phenytoin levels may be associated with the use of adding phenytoin intraoperatively to reduce the incidence of postoperative seizures. The aim of our study was to determine the plasma phenytoin levels in intraoperative period which can determine early postoperative seizure risk.
SN - 2229-5097
SN - 2152-7806
ER -