title: The effect of antiepileptic drugs on coagulation and bleeding in the perioperative period of epilepsy surgery: the Cleveland Clinic experience.
abstract: Antiepileptic drugs (AED) are known to cause coagulation disturbances. We retrospectively analyzed the effect of AED on coagulation parameters in children who underwent craniotomy for epilepsy surgery. A total of 84 children were included. Perioperative coagulation parameters, the number and type of AED, estimated blood loss and the amount of blood products transfused were recorded. The most commonly used AED was lamotrigine. Of all patients, 7.1% were taking valproate. None of the patients showed significantly abnormal prothrombin time, activated partial thromboplastin time, or platelet count preoperatively. Thirty-eight percent of patients were transfused with allogeneic red blood cells and 4.7% of all patients showed significant coagulopathy intraoperatively and postoperatively. We concluded that the number of AED does not appear to be associated with preoperative coagulation disorders or blood transfusion requirements. However, caution should be taken in patients taking AED who undergo complex brain epilepsy surgery due to the potential for significant blood loss.
authors.affiliation: Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Manohar
authors.forename: Rafi
authors.initials: R
authors.lastname: Avitsian
authors.forename: Sara
authors.initials: S
authors.lastname: Lozano
authors.forename: Jorge
authors.initials: J
authors.lastname: Gonzalez-Martinez
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D002648:Child; D003399:Craniotomy / Q000009:adverse effects*; D004827:Epilepsy / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D059035:Perioperative Period / Q000379:methods; D010976:Platelet Count; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants