In dogs undergoing extrahepatic portosystemic shunt attenuation, does pretreatment with levetiracetam reduce postoperative seizure incidence?

Connor Hawes, K. Lazzerini
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Abstract

PICO question PICO   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Four papers were critically reviewed. All were retrospective cohort studies Strength of evidence Moderate Outcomes reported In one paper levetiracetam was found to reduce the risk of post-attenuation seizures. In the remaining three papers no difference was found between the frequency of post-attenuation seizures and the use of levetiracetam Conclusion That prophylactic levetiracetam is not indicated for the use of preventing post-attenuation seizures in dogs surgically treated for extrahepatic portosystemic shunts   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  
在肝外门系统分流衰减的犬中,左乙拉西坦预处理是否能降低术后癫痫发作的发生率?
PICO问题PICO临床底线研究问题类别治疗研究设计的数量和类型审查了四篇论文。所有研究均为回顾性队列研究证据强度中等结果报道在一篇论文中发现左乙拉西坦可降低衰减后癫痫发作的风险。其余3篇论文均未发现衰减后癫痫发作的频率与左乙拉西坦的使用有差异结论左乙拉西坦不适合用于预防肝外门静脉分流手术犬的衰减后癫痫发作如何在实践中应用这一证据在实践中的应用应考虑多种因素,不限于:个人的临床专业知识,病人的情况和业主的价值观,你工作的国家,地点或诊所,你面前的个案,治疗和资源的可用性。知识摘要是帮助加强或告知决策的资源。他们不会凌驾于从业者的责任或判断之上,去做对他们照顾的动物最好的事情。
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