Le neurologue : revue clinique et thérapeutique

Abstrait

Clinical Analysis of Hyperammonemia by Perioperative Sodium Valproate Injection Application in Neurosurgery Patients

Yue Chen, Tianyi Xia, Lei Liu, Man Zhu

Introduction: Valproate injection is commonly used during perioperative period in neurosurgery department. Hyperglycemia induced by this drug can lead to hyperammonia-encephalopathy. This article aims to investigate the relationship between hyperammonemia and the perioperative application of sodium valproate injection.

Material and Methods: The blood ammonia status and other clinical features of perioperative patients from January to June 2019 were collected and retrospectively analyzed according to inclusion criteria.

Results: A total of 62 patients were enrolled, in which 37 patients in the hyperammonemia group and 25 patients in the normal group. There were significant differences in pre-ALT and pre-DBIL between the two groups. Blood drug concentration of valproate differentiated between the two groups. Three patients in the hyperammonemia group developed acute confusion. Except for blood ammonia, all the values of testing indicators were within the normal range. There was a moderate positive correlation between ALT and blood ammonia level in the hyperammonemia group.

Conclusion: Although liver function index and plasma concentration of valproic acid are related to the increase of blood ammonia, safe treatment range may not be able to avoid the occurrence of potential adverse events. It is recommended to enhance monitoring.