[Parenteral administration of diphenylhydantoin in the pre- and post-operative course on plasma level measurement].

In the neurosurgical care, postoperative convulsion, the especially in the early postoperative course, is one of major complications because it can spoil an otherwise good surgical result. The present study was intended to investigate the prophylactic use of anticonvulsants on chemical measurement of their plasma levels. Parenteral diphenylhydantoin (DPH) given just before craniotomy failed to maintain high level of DPH in the postoperative course even with pretreatment of oral DPH. On the other hand, preoperative oral phenobarbital administration maintained fairly high level in spite of no prescription on the operative day. Intravenous DPH of 250 mg immediately after craniotomy resulted in fairly high level of DPH throughout the early postoperative course in cases of pretreatment of oral DPH. In reviewing the pharmacokinetics of anticonvulsants, the prophylactic use of anticonvulsants in the early postoperative course was discussed.