Phenobarbital treatment (20 mg/kg iv) had no significant effect on cerebral blood flow or blood pressure and heart rate, measured 60 min after a loading dose, in 7 term newborn infants with mild to moderate hypoxic ischemic encephalopathy examined in the Dept of Paediatrics, Alborg Hospital, Denmark. Phenobarbital imposed no risk of cerebrovascular damage in newborns with fetal distress. [1]

COMMENT. Phenobarbital is the most commonly used anticonvulsant in neonates and has been advocated in the prevention of periventricular hemorrhage in preterm infants. This demonstration of the safety of phenobarbital in neonates with HIE is encouraging and should offset in part the poor rating the drug has received in some febrile seizure studies.