Preoperative valproate administration does not increase blood loss during temporal lobectomy

Mariann M. Ward, Nicholas Barbaro, Kenneth D. Laxer, Ira J. Rampil

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Surgical treatment is increasingly used for patients with medically refractory seizures. Valproate (VPA) is an effective, widely used anticonvulsant in this patient population, but believed by some researchers to increase surgical bleeding because of quantitative thrombocytopenia and functional defects in platelet aggregation. Because we have observed no clinical evidence that perioperative administration of VPA increases blood loss or complications related to postoperative bleeding in patients undergoing temporal lobectomy at our institution, we sought to test this hypothesis. We made a retrospective review of the medical records of all patients who underwent epilepsy surgery at the University of California, San Francisco Medical Center, from September 1986 through January 1993. Patients who had a temporal lobectomy and whose medical records documented preoperative platelet counts and pre- and postoperative hematocrit and hemoglobin values were included. We excluded patients who had cranial surgery before temporal lobectomy and those with intracranial neoplasms or vascular malformations. Patients were divided into two groups: those who received VPA in the immediate preoperative period and those who had not received VPA recently. We compared the estimated surgical blood loss and the estimated change in red blood cell (RBC) volume between groups by unpaired t tests. The charts of 87 consecutive patients qualified for inclusion in the study. Patients in the VPA group had relative (but not absolute) thrombocytopenia preoperatively (235 ± 64 vs. 277 ± 69 k in the No-VPA group). There were no differences in the estimated blood loss, RBC volume, or in the incidence of postoperative transfusion. VPA apparently does not increase complications of hemostasis during therapeutic surgical resections for epilepsy. Therefore, we do not recommend routinely discontinuing VPA before craniotomy.

Original languageEnglish (US)
Pages (from-to)98-101
Number of pages4
JournalEpilepsia
Volume37
Issue number1
DOIs
StatePublished - Jan 1996
Externally publishedYes

Fingerprint

Valproic Acid
Blood Volume
Cell Size
Thrombocytopenia
Medical Records
Epilepsy
Erythrocytes
Surgical Blood Loss
Hemorrhage
Preoperative Period
Vascular Malformations
San Francisco
Craniotomy
Hemostasis
Platelet Count
Platelet Aggregation
Hematocrit
Brain Neoplasms
Anticonvulsants
Hemoglobins

Keywords

  • Coagulopathy
  • Platelets
  • Temporal lobectomy
  • Valproate

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Preoperative valproate administration does not increase blood loss during temporal lobectomy. / Ward, Mariann M.; Barbaro, Nicholas; Laxer, Kenneth D.; Rampil, Ira J.

In: Epilepsia, Vol. 37, No. 1, 01.1996, p. 98-101.

Research output: Contribution to journalArticle

Ward, Mariann M. ; Barbaro, Nicholas ; Laxer, Kenneth D. ; Rampil, Ira J. / Preoperative valproate administration does not increase blood loss during temporal lobectomy. In: Epilepsia. 1996 ; Vol. 37, No. 1. pp. 98-101.
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