RANDOMIZED CONTROLLED TRIAL BETWEEN LEVETIRACETAM AND PHENOBARBITONE IN THE TREATMENT OF NEONATAL SEIZURE DUE TO PERINATAL ASPHYXIA

Background: Seizure occurs more frequently in neonatal period than in any other time of life. Estimated incidence of neonatal seizure varies according to case definition, method of ascertainment and definition of the neonatal period and ranges from 1 to 5 per 1000 live births. Methodology: Neonates admitted in Nicu, department of Paediatrics, Nalanda Medical College and Hospital, Patna in time period of Aug 2023- July 2024. Sample size was 100. For seizure control in neonates with active convulsion either levetiracetam or phenobarbitone was allocated to the randomization. Intravenous levetiracetam is given at a loading dose of 20 mg/kg. Maintenance is given at a dose of 10mg/kg 8 hourly. Intravenous phenobarbitone is given at a dose of 20mg/kg and 5mg/kg 12hrly of maintenance dose. Results: In levetiracetam Group, 23(46.0%) patients had1number of loading dose required, 14(28.0%) patients had 2 number of loading dose required and 13(26.0%) patient had 3number of loading dose required. In phenobarbitone Group, 28(56.0%) patients had 1number of loading dose required, 9(18.0%) patients had 2 number of loading dose required and 13(26.0%) patient had 3 number of loading dose required. Conclusion: Higher neonates were required only one loading dose of AED in phenobarbitone group compared to levetiracetam group .Majority patients needed 10 minute time period for termination of acute seizure in phenobarbitone group compared to levetiracetam group. Mortality rate was higher in phenobarbitone group compared to levetiracetam group.