Comparative study on the efficacy of intranasal midazolam versus intravenous midazolam and intravenous diazepam in convulsing neonates and children

ORIGINAL ARTICLE

COMPARATIVE STUDY ON THE EFFICACY OF INTRANASAL MIDAZOLAM VERSUS INTRAVENOUS MIDAZOLAM AND INTRAVENOUS DIAZEPAM IN CONVULSING NEONATES AND CHILDREN

Richa Sharma, Rekha Harish.

Department of Pediatrics, Government Medical College, Jammu, India.

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Abstract
Aim: To compare the clinical efficacy of two routes of midazolam intranasal vs. intravenous, in relation to intravenous diazepam for control of seizures.

Methods: A prospective randomized study conducted on 150 convulsing patients of 0-19 years of age hospitalized in pediatric emergency ward and neonatal intensive care unit (NICU). Group-I was given intranasal midazolam at 0.3 mg /kg, Group-II was given intravenous midazolam at 0.3mg/kg and Group-III was given intravenous diazepam at 0.3 mg /kg. Outcome was measured in terms of time taken from physician contact to drug administration and the time taken from drug administration to cessation of seizures.

Results: Mean time from physician contact to drug administration was significantly shorter with intranasal midazolam as compared to intravenous midazolam and intravenous diazepam (0.40±0.10min vs. 1.06±0.40 min and 1.06±40 min) (p-0.03). Mean time from drug administration to cessation of seizures was lesser in midazolam (1.6 ± 0.3mins(IN) and 1.6±0.3min(IV) as compared to diazepam (2.26±0.6 min) (p-0.06). However this difference was statistically insignificant. The vital parameters or oxygen saturation did not reveal any statistically significant difference between the three groups.

Conclusion: Seizure control was most prompt with intranasal midazolam.

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