From the Guidelines
Levetiracetam (Keppra) loading dose should be administered at a dose of 1,500 mg oral load or rapid IV loading safe and well tolerated in doses up to 60 mg/kg, with the timing in relation to anesthesia induction not explicitly stated in the provided evidence, but it is crucial to administer the loading dose to reach therapeutic levels before the stress of surgery. The provided evidence from 1 suggests that the loading dose and route of administration for Levetiracetam (Keppra) is 1,500 mg oral load or rapid IV loading safe and well tolerated in doses up to 60 mg/kg. Some key points to consider when administering Levetiracetam (Keppra) include:
- The medication has a favorable side effect profile, with fatigue, dizziness, and rarely pain at the infusion site being reported 1.
- The exact timing of administration in relation to anesthesia induction is not specified in the provided evidence, but it is generally recommended to administer the loading dose to reach therapeutic levels before the stress of surgery.
- Levetiracetam (Keppra) works by binding to synaptic vesicle protein SV2A, modulating neurotransmitter release and stabilizing neuronal membranes, which makes it an effective medication for seizure prophylaxis.
- It is essential to continue regular antiepileptic medications up to the day of surgery unless otherwise instructed by a healthcare professional.
From the Research
Pre-operative Keppra (Levetiracetam) Loading Dose Timing
- The timing of a pre-operative Keppra (levetiracetam) loading dose in relation to anesthesia induction is not explicitly stated in the provided studies as a specific time frame, but it can be inferred from the study protocols.
- In the study by 2, 1000 mg of levetiracetam was administered before skin incision in cases with a history of seizures.
- The study by 3 mentions that patients received between 1,000 mg and 3,000 mg of levetiracetam perioperatively, but does not specify the exact timing in relation to anesthesia induction.
- Another study 4 administered levetiracetam (1000-3000 mg) and/or perampanel (2-4 mg) before surgery, but the exact timing relative to anesthesia induction is not provided.
Administration Methods and Timing
- A study on the efficiency and safety of high-dose undiluted intravenous push levetiracetam loading doses compared to intravenous infusion in seizing patients 5 found that the median time to administration was shorter in the intravenous push group (12 vs. 38 minutes, p < .001), but this study does not directly address the timing in relation to anesthesia induction.
- The provided evidence does not offer a uniform recommendation for the timing of a pre-operative levetiracetam loading dose specifically in relation to anesthesia induction, suggesting variability in clinical practice.