Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
Vol. 22, No. 1, 2012, pp. 1-8
Bioline Code: pe12001
Full paper language: English
Document type: Research Article
Document available free of charge
Iranian Journal of Pediatrics, Vol. 22, No. 1, 2012, pp. 1-8
© Copyright 2012 - Iran Journal of Pediatrics
Intranasal Midazolam Compared with Intravenous Diazepam in Patients Suffering from Acute Seizure: A Randomized Clinical Trial|
Javadzadeh, Mohsen; Sheibani, Kourosh; Hashemieh, Mozhgan & Saneifard, Hedyeh
Objective: Acute seizure attack is a stressful experience both for health care personnel and parents. These
attacks might cause morbidity and mortality among patients, so reliable methods to control the seizure
preferably at home should be developed. This study was performed to measure the time needed to control
seizure attacks using intranasal midazolam compared to the common treatment (intravenous diazepam) and
to evaluate its probable side effects.
Methods: This study was conducted as a not blind randomized clinical trial among 60 patients coming to
Imam Ali Hospital, Zahedan, Iran. The patients were 2 months to 15 years old children coming to our
emergency department suffering from an acute seizure episode. Intranasal midazolam was administered 0.2
mg/kg equally dropped in both nostrils for case group and intravenous diazepam was administered 0.3mg/kg
via IV line for control group. After both treatments the time needed to control the seizure was registered by
the practitioner. Pulse rate and O2 saturation were recorded at patients’ entrance and in minutes 5 and 10
after drug administration.
Findings: The time needed to control seizure using intranasal midazolam (3.16±1.24) was statistically shorter
than intravenous diazepam (6.42±2.59) if the time needed to establish IV line in patients treated by
intravenous diazepam is taken into account (P<0.001). The readings for O2 saturation or heart rate did not
indicate a statistically significant difference between two groups of patients either at entrance or 5 and 10
minutes after drug administration.
Conclusion: Considering the shorter time needed to control acute seizure episodes compared to intravenous
diazepam and its safety record, intranasal midazolam seems to be a good candidate to replace diazepam, as
the drug of choice, in controlling this condition.
Midazolam; Diazepam; Seizures; Clinical Trail
Alternative site location: http://diglib.tums.ac.ir/pub/