Effect of phenobarbital on free radicals in neonates with hypoxic ischemic encephalopathy--a randomized controlled trial.
BACKGROUND
Phenobarbital is one of the oldest, cheapest and easily available cerebroprotective drugs for the hypoxic brain. However, its potential and various actions have not been fully explored.


OBJECTIVE
To evaluate the effects of Phenobarbital on levels of oxidants and anti-oxidants in term and near term neonates with hypoxic ischemic encephalopathy.


METHODS
Design--randomized controlled trial. Setting--tertiary care referral perinatal centre. Procedure--asphyxiated neonates (gestation > or = 34 weeks) with HIE were randomized to receive Phenobarbital 20 mg/kg i.v. within first six hours of life or to control group. CSF levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx) and blood levels of vitamins A and E were estimated at 10-12 hours of age.


RESULTS
CSF levels of MDA, SOD, GPx and blood levels of vitamins A and E were significantly lower in the Phenobarbital group (p<0.001). There was a trend towards lower levels of CSF MDA, SOD, GPx and blood vitamins A and E in babies with normal outcome as compared to babies with adverse outcome (death or neurologically abnormal at discharge).


CONCLUSIONS
Phenobarbital in the dose of 20 mg/kg i.v. given within 6 hours of life in term and near-term neonates with HIE, was associated with a decrease in lipid peroxides, anti-oxidant enzymes and anti-oxidant vitamins.
Singh
Daljit
D
Neonatal Unit, Department of Pediatrics, Advanced Pediatrics Center, PGIMER, Chandigarh, India.
Kumar
Praveen
P
Majumdar
Siddhartha
S
Narang
Anil
A
D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005609:Free Radicals / Q000134:cerebrospinal fluid*; D005979:Glutathione Peroxidase / Q000134:cerebrospinal fluid / Q000187:drug effects; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000188:drug therapy* / Q000473:pathology; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D008315:Malondialdehyde / Q000134:cerebrospinal fluid; D010634:Phenobarbital / Q000008:administration & dosage / Q000627:therapeutic use*; D013482:Superoxide Dismutase / Q000134:cerebrospinal fluid / Q000187:drug effects; D016896:Treatment Outcome
D000927:Anticonvulsants; D005609:Free Radicals; D008315:Malondialdehyde; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase; D010634:Phenobarbital