Department of Neurosurgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, QLD 4102, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Department of Neurosurgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, QLD 4102, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
J Clin Neurosci. 2022 Sep;103:112-118. doi: 10.1016/j.jocn.2022.07.014. Epub 2022 Jul 19.
Prophylactic antiepileptic drug (pAED) use for craniotomy surgery is currently not supported in literature [1-5] except possibly in traumatic brain injury (TBI) [6]. Post craniotomy driving restrictions using the Austroad guidelines are based upon literature on TBI and not specifically craniotomy [16-18]. This study was to review Australian and New Zealand neurosurgeons on their use of pAED and advice on driving restrictions post craniotomy surgery. A voluntary and anonymous survey link was distributed to the members of the Neurosurgical Society of Australasia (NSA) through the NSA newsletter. The survey was available on the SurveyMonkey platform in the year 2021 August to December. Questions regarding the use of pAED and duration of driving restrictions were presented to survey participants. Sixty-one (26 %) out of 231 neurosurgeons responded to the survey. Thirty-six percent of respondents stated that they prescribed pAEDs regularly whilst thirty-two percent of respondents did not routinely prescribe pAEDs for craniotomy surgery. Driving restrictions varied but the most common driving restriction post craniotomy surgery was 6 months. There were divided opinions among NSA members in regards to pAED use and driving restrictions. The rationale for pAED use and prolonged driving restrictions for craniotomy surgery needs to be re-evaluated with current literature. The significant effect this may have on the well-being and quality life of patients need to be considered before prescribing pAEDs or long driving restrictions.
预防性抗癫痫药物（pAED）在开颅手术中的使用目前在文献中得不到支持[1-5]，除非可能在创伤性脑损伤（TBI）中[6]。根据 Austroad 指南，开颅手术后的驾驶限制是基于 TBI 文献，而不是专门针对开颅手术[16-18]。本研究旨在调查澳大利亚和新西兰神经外科医生对 pAED 的使用情况以及开颅手术后驾驶限制的建议。通过神经外科学会（NSA）的通讯向 NSA 的成员分发了一份关于 pAED 使用和开颅手术后驾驶限制的自愿和匿名调查链接。该调查于 2021 年 8 月至 12 月在 SurveyMonkey 平台上进行。向调查参与者提出了关于使用 pAED 和驾驶限制持续时间的问题。在 231 名神经外科医生中，有 61 名（26%）对调查做出了回应。36%的受访者表示他们经常开 pAED，而 32%的受访者则不开 pAED 常规用于开颅手术。驾驶限制各不相同，但最常见的开颅手术后驾驶限制是 6 个月。NSA 成员在 pAED 使用和驾驶限制方面存在分歧意见。需要根据当前文献重新评估开颅手术中使用 pAED 和延长驾驶限制的理由。在开具 pAED 或长期驾驶限制之前，需要考虑这可能对患者的幸福感和生活质量产生的重大影响。
