Comparison of intranasal midazolam with intravenous diazepam for treatment of acute seizures in children: A randomized controlled trial

摘要

Objective: To compare efficacy and safety of intranasal Midazolam with intravenous Diazepam for control of acute seizures in children Study Design: Randomized Control Trial Place and Duration: Department of Paediatrics, Fauji Foundation Hospital, Rawalpindi for a duration of 6 months from 2nd July to 31st December 2018 Methodology: Children between the ages of 3 months to 12 years presenting during a seizure episode were randomized into two groups. In Group A, patients were given 0.2mg/kg intranasal Midazolam administrated as drops in both nostrils. In Group B, patients were given 0.3mg/kg Diazepam intravenously. Sedation levels and vital signs were noted before, after 5 minutes and 10 minutes of administration of the two drugs. The time duration from arrival of patient in the hospital to start of treatment, and from commencement of treatment to cessation of seizures was recorded and compared between the two groups. Results: Results showed that the mean time from arrival at hospital to start of treatment was significantly shorter (p 0.05) in the Midazolam group as compared to the Diazepam group (2.07 0.27 vs. 5.06 0.81 minutes). The mean time to control seizures after arrival in hospital was also significantly shorter (0.05) in IN Midazolam group in comparison to Diazepam group (5.43 2.82 vs. 7.66 2.39 minutes). No serious adverse side effect was observed in Midazolam group. Conclusion: Intranasal Midazolam is an effective noninvasive method for control of acute seizures in children.