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Intramuscular midazolam versus intravenous diazepam for treatment of seizures in the pediatric emergency department: a randomized clinical trial.
- Source :
-
Medicina intensiva [Med Intensiva] 2015 Apr; Vol. 39 (3), pp. 160-6. Date of Electronic Publication: 2014 Jun 10. - Publication Year :
- 2015
-
Abstract
- Aim: To compare the therapeutic efficacy of intramuscular midazolam (MDZ-IM) with that of intravenous diazepam (DZP-IV) for seizures in children.<br />Design: Randomized clinical trial.<br />Setting: Pediatric emergency department.<br />Patients: Children aged 2 months to 14 years admitted to the study facility with seizures.<br />Intervention: Patients were randomized to receive DZP-IV or MDZ-IM.<br />Main Measurements: Groups were compared with respect to time to treatment start (min), time from drug administration to seizure cessation (min), time to seizure cessation (min), and rate of treatment failure. Treatment was considered successful when seizure cessation was achieved within 5min of drug administration.<br />Results: Overall, 32 children (16 per group) completed the study. Intravenous access could not be obtained within 5min in four patients (25%) in the DZP-IV group. Time from admission to active treatment and time to seizure cessation was shorter in the MDZ-IM group (2.8 versus 7.4min; p<0.001 and 7.3 versus 10.6min; p=0.006, respectively). In two children per group (12.5%), seizures continued after 10min of treatment, and additional medications were required. There were no between-group differences in physiological parameters or adverse events (p=0.171); one child (6.3%) developed hypotension in the MDZ-IM group and five (31%) developed hyperactivity or vomiting in the DZP-IV group.<br />Conclusion: Given its efficacy and ease and speed of administration, intramuscular midazolam is an excellent option for treatment of childhood seizures, enabling earlier treatment and shortening overall seizure duration. There were no differences in complications when applying MDZ-IM or DZP-IV.<br /> (Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)
- Subjects :
- Adolescent
Anticonvulsants adverse effects
Anticonvulsants therapeutic use
Child
Child, Preschool
Diazepam adverse effects
Diazepam therapeutic use
Emergency Service, Hospital
Female
Humans
Hypotension chemically induced
Infant
Injections, Intramuscular
Injections, Intravenous
Male
Midazolam adverse effects
Midazolam therapeutic use
Nausea chemically induced
Pediatrics
Time Factors
Anticonvulsants administration & dosage
Diazepam administration & dosage
Midazolam administration & dosage
Seizures drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1578-6749
- Volume :
- 39
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Medicina intensiva
- Publication Type :
- Academic Journal
- Accession number :
- 24928286
- Full Text :
- https://doi.org/10.1016/j.medin.2014.04.003