ArticleNeurocritical care2026
Valproic acid for the management of agitation in neurosurgical intensive care unit patients.
Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Revisiting the Role of Valproic Acid in Neurosurgical ICU Agitation.Neurocritical care · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeurosurgical patients are at an increased risk of developing agitation and intensive care unit (ICU) delirium due to direct inflammation and oxidative stress associated with neurosurgery. There are limited therapeutic options for the management of agitation and delirium in this population; and neurosurgical patients have been largely underrepresented in previous studies. This study aimed to assess the impact of valproic acid (VPA) on adjunctive agent requirements for the management of agitation in neurosurgical ICU patients.
methodsThis was a single-center, retrospective, descriptive study evaluating adult neurosurgical patients admitted between 1 April 2016 and 31 August 2023. Patients were included if they were on VPA for at least 3 days for the treatment of agitation. The primary outcome evaluated changes in total daily doses (TDD) of adjunctive sedative agent requirements following VPA initiation. Secondary outcomes included the incidence of positive Richmond Agitation and Sedation Scale (RASS) scores and liberation from physical restraints. Safety outcomes included the occurrence of thrombocytopenia, hyperammonemia, and liver function test (LFT) abnormalities while on VPA.
resultsA total of 91 patients were included in the analysis. Significant reductions in TDD of opioids (p = 0.001), benzodiazepines (p = 0.003), and dexmedetomidine (p < 0.001) were seen on day 3 of VPA therapy. Significant reductions in the number of patients with positive RASS scores (p = 0.001) and the number of patients requiring physical restraints (p = 0.001) were also observed from day 1 to day 3 of VPA therapy.
conclusionsInitiation of VPA was associated with a significant decrease in adjunctive sedative agent requirements, positive RASS scores, and number of patients requiring physical restraints. Further prospective studies are needed to determine the optimal role of VPA for the management of agitation in neurosurgical ICU patients.
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