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Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
ISSN: 1018-4406
EISSN: 2008-2150
Vol. 22, No. 3, 2012, pp. 303-308
Bioline Code: pe12056
Full paper language: English
Document type: Research Article
Document available free of charge

Iranian Journal of Pediatrics, Vol. 22, No. 3, 2012, pp. 303-308

 en A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children
Tonekaboni, Seyed-Hassan; Shamsabadi, Farhad Mahvelati; Anvari, Seyed-Saeed; Mazrooei, Ali & Ghofrani, Mohammad

Abstract


Objective: The purpose of the present study is to compare efficacy and safety of buccal midazolam with intravenous diazepam in control of seizures in Iranian children.
Methods: This is a randomized clinical trial. 92 patients with acute seizures, ranging from 6 months to 14 years were randomly assigned to receive either buccal midazolam (32 cases) or intravenous diazepam (60 cases) at the emergency department of a children's hospital. The primary outcome of this study was cessation of visible seizure activity within 5 minutes from administration of the first dosage. The second dosage was used in case the seizure remained uncontrolled 5 minutes after the first one.
Findings: In the midazolam group, 22 (68.8%) patients were relieved from seizures in 10 minutes. Meanwhile, diazepam controlled the episodes of 42 (70%) patients within 10 minutes. The difference was, however, not statistically significant (P=0.9). The mean time required to control the convulsive episodes after administration of medications was not statistically significant (P=0.09). No significant side effects were observed in either group. Nevertheless, the risk of respiratory failure in intravenous diazepam is greater than in buccal midazolam.
Conclusion: Buccal midazolam is as effective as and safer than intravenous diazepam in control of seizures.

Keywords
Midazolam; Diazepam; Seizure; Buccal Drug Administration; Intravenous Injections; Childhood

 
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