Introduction: Patients are treated for refractory status epilepticus (RSE) with either midazolam, propofol, or pentobarbital, in addition to other concomitant anti-epileptic drugs (AEDs). Pentobarbital has a lower RSE treatment failure rate than midazolam or propofol, but patients often experience serious adverse effects (AEs) when pentobarbital is used, leading providers to reserve this medication as last-line therapy. We present a series of patients treated within the University of Utah health system for RSE with pentobarbital and discuss the adverse effects experienced by these cases.
Methods: This retrospective study included adult patients treated for RSE with pentobarbital between July 2014 and June 2019. The primary aims of this study were to describe the incidence of AEs and to evaluate the AE management methods at U of U Hospital. AEs were graded according to the severity and reported if management required hospitalization and advanced treatment. AE management methods were described.
Results and Discussion: AEs experienced by the patients were reported. 3 of the patients died from adverse effects related to the AED medication administration. Only 2 patients experienced ileus that required treatment. Adverse effects did not appear to be associated with the maximum dose of pentobarbital that a patient received during admission. Most of the patients treated with pentobarbital experienced hyponatremia during their hospital admission.