Intravenous lidocaine in the treatment of convulsions in the neonatal period: monitoring plasma levels.
Thirteen newborn infants (five premature, eight full term) with severe seizures and not responding to phenobarbital and diazepam received a lidocaine (LD) infusion. The schedule was 4 mg/kg/h on the 1st day, 3 mg/kg/h on the 2nd day, 2 mg/kg/h on the 3rd day, and 1 mg/kg/h on the 4th day. The LD plasma levels were measured every 24 h just before decreasing the dose. The control of seizures was achieved in 11 of 13 patients, with plasma LD concentration ranging from 2.8 to 10.5 mg/L. The LD concentration was linearly correlated with the dose in each group. In the premature group, LD clearance was always smaller than in the full-term group. Although no side effects were observed on heart rate and blood pressure, it is suggested that the dose of LD be adjusted to maintain the LD concentrations between 3-6 mg/L.
Département de Pharmacologie Périnatale et Pédiatrique, Hôpital Saint-Vincent de Paul, Paris, France.
E
E
Rey
M F
MF
Radvanyi-Bouvet
C
C
Bodiou
M O
MO
Richard
A
A
Torricelli
H
H
Walti
G
G
Olive
D003975:Diazepam / Q000097:blood; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D007234:Infant, Premature / Q000097:blood; D007262:Infusions, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012640:Seizures / Q000188:drug therapy* / Q000378:metabolism
D008012:Lidocaine; D003975:Diazepam