The Relationship of Developing Metabolic Acidosis With Antiepleptic Drugs in Craniotomy Operations

Study Overview
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Brief Summary
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The relationship of developing metabolic acidosis with antiepleptic drugs in craniotomy operations

Detailed Description
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Metabolic acidosis is a life-threatening complication in the perioperative, intraoperative and postoperative period. It can cause decreased cardiac output, electrolyte imbalance, surgical bleeding and neurological complications, even coma and death in surgical patients. Topiramate and zonisamide are sulfonamide derivative compounds used in the treatment of epilepsy. It has been shown in studies that both drugs have a strong inhibition of carbonic anhydrase enzyme. Recent case reports suggest that both drugs may cause metabolic acidosis by lowering serum bicarbonate levels in some patients. Aim in this study is to determine the relationship between preoperative, intraoperative and postoperative metabolic acidosis and to emphasize the importance of anesthesia management in patients who have undergone craniotomy and use antiepileptic drugs.

Official Title
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The Relationship of Developing Metabolic Acidosis With Antiepleptic Drugs in Craniotomy Operations; Does Topiramat or Zonisamide Cause Metabolic Acidosis?

Conditions
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Metabolic Acidosis, Antiepileptic Drugs, Craniotomy, Anesthesia Management

Intervention / Treatment
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* Procedure: Arterial Blood Gas Base Deficit


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing intracranial surgery with craniotomy and using antiepileptic drugs ASA I-III Patients undergoing elective surgery Exclusion Criteria: Patients with a surgical procedure time of more than 5 hours Patients who received more than 2 units of blood transfusion during the operation Patients taking other drugs that can cause metabolic acidosis Patients with diabetes mellitus, diabetes insipidus, hepatic or renal disease

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group 1<br>Patients who have used Zonisamide or Topiramate | Procedure: Arterial Blood Gas Base Deficit<br>* The base deficit values in the preoperative, intraoperative and postoperative blood gases taken from the patients and the presence and severity of metabolic acidosis were evaluated. Metabolic acidosis severity was defined by base deficit levels: mild from -3 to -5, moderate from -5 to -10, and severe metabolic acidosis below -10.<br>|
| Group 2<br>Patients who have used Lacosamide | Procedure: Arterial Blood Gas Base Deficit<br>* The base deficit values in the preoperative, intraoperative and postoperative blood gases taken from the patients and the presence and severity of metabolic acidosis were evaluated. Metabolic acidosis severity was defined by base deficit levels: mild from -3 to -5, moderate from -5 to -10, and severe metabolic acidosis below -10.<br>|
| Group 3<br>Patients who have used Carbamazepine | Procedure: Arterial Blood Gas Base Deficit<br>* The base deficit values in the preoperative, intraoperative and postoperative blood gases taken from the patients and the presence and severity of metabolic acidosis were evaluated. Metabolic acidosis severity was defined by base deficit levels: mild from -3 to -5, moderate from -5 to -10, and severe metabolic acidosis below -10.<br>|
| Group 4<br>Patients who have used levetiracetam | Procedure: Arterial Blood Gas Base Deficit<br>* The base deficit values in the preoperative, intraoperative and postoperative blood gases taken from the patients and the presence and severity of metabolic acidosis were evaluated. Metabolic acidosis severity was defined by base deficit levels: mild from -3 to -5, moderate from -5 to -10, and severe metabolic acidosis below -10.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Preoperative Metabolic Acidosis | The base deficit values in the preoperative, intraoperative and postoperative blood gases taken from the patients and the presence and severity of metabolic acidosis were evaluated. Metabolic acidosis severity was defined by base deficit levels: mild from -3 to -5, moderate from -5 to -10, and severe metabolic acidosis below -10. | Baseline | 
| Intraoperative Metabolic Acidosis | The base deficit values in the preoperative, intraoperative and postoperative blood gases taken from the patients and the presence and severity of metabolic acidosis were evaluated. Metabolic acidosis severity was defined by base deficit levels: mild from -3 to -5, moderate from -5 to -10, and severe metabolic acidosis below -10. | during the operation | 
| Postoperative Metabolic Acidosis | The base deficit values in the preoperative, intraoperative and postoperative blood gases taken from the patients and the presence and severity of metabolic acidosis were evaluated. Metabolic acidosis severity was defined by base deficit levels: mild from -3 to -5, moderate from -5 to -10, and severe metabolic acidosis below -10. | Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Antiepileptic Drugs, Metabolic Acidosis, Anesthesia Management, Craniotomy