TY - JOUR
T1 - A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children
AU - Chamberlain, James M.
AU - Altieri, Michael A.
AU - Futterman, Craig
AU - Young, Grace M.
AU - Ochsenschlager, Daniel W.
AU - Waisman, Yeheskel
PY - 1997/4
Y1 - 1997/4
N2 - Objective: To compare treatment of ongoing seizures using intramuscular (IM) midazolam versus intravenous (IV) diazepam. Design: Controlled clinical trial. Patients: Children with motor seizures of at least 10 minutes' duration. Main outcome measures: Time to cessation of seizures. Results: Twenty-four patients were enrolled (13 midazolam, 11 diazepam). Initial treatment with either midazolam or diazepam was successful in 22 of the 24 patients. One patient in each group failed therapy and eventually required endotracheal intubation and general anesthesia for convulsive status epilepticus lasting more than one hour. Patients in the midazolam group received medication sooner (3.3 ± 2.0 vs 7.8 ± 3.2 minutes, P = 0.001) and had more rapid cessation of their seizures (7.8 ± 4.1 vs 11.2 ± 3.6, P = 0.047) than patients randomized to receive diazepam. Conclusions: IM midazolam is an effective anticonvulsant for children with motor seizures. Compared to IV diazepam, IM midazolam results in more rapid cessation of seizures because of more rapid palministration. The IM route of administration may be particularly useful in physicians' offices, in the prehospital setting, and for children with difficult IV access.
AB - Objective: To compare treatment of ongoing seizures using intramuscular (IM) midazolam versus intravenous (IV) diazepam. Design: Controlled clinical trial. Patients: Children with motor seizures of at least 10 minutes' duration. Main outcome measures: Time to cessation of seizures. Results: Twenty-four patients were enrolled (13 midazolam, 11 diazepam). Initial treatment with either midazolam or diazepam was successful in 22 of the 24 patients. One patient in each group failed therapy and eventually required endotracheal intubation and general anesthesia for convulsive status epilepticus lasting more than one hour. Patients in the midazolam group received medication sooner (3.3 ± 2.0 vs 7.8 ± 3.2 minutes, P = 0.001) and had more rapid cessation of their seizures (7.8 ± 4.1 vs 11.2 ± 3.6, P = 0.047) than patients randomized to receive diazepam. Conclusions: IM midazolam is an effective anticonvulsant for children with motor seizures. Compared to IV diazepam, IM midazolam results in more rapid cessation of seizures because of more rapid palministration. The IM route of administration may be particularly useful in physicians' offices, in the prehospital setting, and for children with difficult IV access.
KW - Status epilepticus
KW - diazepam
KW - midazolam
KW - seizures
UR - http://www.scopus.com/inward/record.url?scp=0030948363&partnerID=8YFLogxK
U2 - 10.1097/00006565-199704000-00002
DO - 10.1097/00006565-199704000-00002
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C2 - 9127414
AN - SCOPUS:0030948363
SN - 0749-5161
VL - 13
SP - 92
EP - 94
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
IS - 2
ER -