gms | German Medical Science

64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. - 29. Mai 2013, Düsseldorf

Artikel

Artikel empfehlen

Enteral or parenteral nimodipine treatment in vestibular schwannoma surgery – a comparative pharmacokinetic study

Meeting Abstract

Suche in Medline nach

  • Christian Scheller - Department of Neurosurgery, University of Halle-Wittenberg, Germany
  • Andreas Wienke - Institute of Medical Epidemiology, Biostatistics, and Informatics, University of Halle-Wittenberg, Germany
  • Franziska Wurm - Department of Neurosurgery, University of Halle-Wittenberg, Germany
  • Sebastian Simmermacher - Department of Neurosurgery, University of Halle-Wittenberg, Germany
  • Eva Herzfeld - Department of Neurosurgery, University of Halle-Wittenberg, Germany
  • Christian Strauss - Department of Neurosurgery, University of Halle-Wittenberg, Germany

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMI.10.08

doi: 10.3205/13dgnc364, urn:nbn:de:0183-13dgnc3640

Veröffentlicht: 21. Mai 2013

© 2013 Scheller et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Objective: Oral nimodipine is recommended to reduce poor outcome related to aneurysmal subarachnoid hemorrhage (SAH). In addition, animal experiments and clinical trials revealed a beneficial effect of enteral and parenteral nimodipine for the regeneration of cranial nerves following skull base, laryngeal and maxillofacial surgery. Despite these findings there is a lack of pharmacokinetic data in the literature, especially concerning its distribution in nerve tissue.

Method: Samples were taken from a consecutive series of 57 patients suffering from skull base lesions and treated with nimodipine prophylaxis from the day before surgery until the seventh postoperative day. Both groups received standard dosages for enteral (n=25) and parenteral (n=32) nimodipine medication. Nimodipine levels were measured in serum, cerebrospinal fluid (CSF), and tissue samples including vestibular nerves.

Results: Nimodipine levels were significantly higher following parenteral as compared to enteral administration for intraoperative serum (p<0.001), intraoperative CSF (p<0.001), tumor tissues (p=0.01) and postoperative serum (p<0.001). In addition, nimodipine was significantly more frequently detected in nerve tissue following parenteral administration (Fisher`s exact test, p=0.015).

Conclusions: From a pharmacokinetic point of view parenteral nimodipine medication leads to higher levels in serum and CSF. Furthermore, traces are more frequently found in nerve tissue following parenteral as compared to enteral nimodipine administration, at least in the early course.