1. It is not clear how clinical seizures were diagnosed and by whom, as the sensitivity of clinical assessment is just about 50%.

2. Exclusion of babies who needed ventilation may make the results erroneous as the respiratory depression induced by phenobarbitone itself may have caused such a need.

3. In practice, it is very difficult to achieve a rate of infusion of 1 mg/kg/min for a 20 min duration. How did the authors achieve the same?

4. Why did authors measure serum levels immediately after the infusion? It is usually recommended to measure peak level after 2 hours [2].

5. In the abstract, the authors seem to make a potentially dangerous generalization that drug level monitoring is unnecessary. If so, how do we diagnose the CNS depression and other adverse effects related to phenobarbitone toxicity?

6. The number of children having seizures related to hypoxic ischemic encephalopathy is not quoted.