All issues > Volume 32(9); 1989

Original Article

J Korean Pediatr Soc. 1989;32(9):1265-1272. Published online September 30, 1989.

Blood Level of Phenobarbital in Treatment of Seizure After Neonatal Asphyxia.

Ji Yean Lee¹, Heng Mi Kim¹, Doo Hong Ahn¹

¹Department of Pediatrics, Kyungpook National University, School of Medicine, Taegu, Korea

Received: March 2, 1989;  Accepted: April 20, 1989.

Abstract

In this study, we attempted to determine an optimal first dose of phenobarbital for the treatment of seizures in the asphyxiated full term neonates. Blood samples were obtained 2 to 48 hours after the administration of final effective loading dose and plasma levels were determined by the EMIT system. Four groups of neonates were studied. Six neonates (Group 1) received an intravenous loading dose of 10 mg/kg a day followed by a maintenance dose of 5 mg/kg a day. Seven neonates (Group 2) received 15 mg/kg a day followed by 4 mg/kg a day, 5 neonates (Group 3) received 20 mg/kg a day followed by 3.4 mg/kg a day and 2 neonates (Group 4) received 30 mg/kg a day followed by 4 mg/kg. Following intravenous administrations of 10 mg/kg, 15 mg/kg, 20 mg/kg and 30 mg/kg, levels of 5. 4±1.8jtzg/ml, 25.0±8.2 ^g/ml, 27.5± 5.8 #g/ml and 50.1 ±1.1 //g/ml were achieved 2 hours after injection respectively. Increasing serum levels were observed in group 1 cases. In 13 of the neonates the plasma levels allowed attemps to evaluate the anti-convulsive effect of phenobarbital. In 9 cases (64.2%) who phenobarbital seemed to be effective, the minimal level of phenobarbital concentration when seizures ceased was 13.7 /zg/ml and average concentration was 28. 4±10.0 //g/ml.

Keywords :Neonate, Seizures, Phenobarbital