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22 Jul 2020
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Intramuscular marginally better than buccal midazolam for paediatric seizure

2 days ago

Intramuscular midazolam appears to be better than buccal administrations for first-line treatment of paediatric seizures, a recent study has found.

Researchers enrolled 150 children with active seizures. Half of the participants received midazolam intramuscularly (mean age, 49±46 months), while the other half were given buccal midazolam (mean age, 45±37 months). The primary efficacy outcome was the proportion of patients with seizure cessation within 5 minutes of drug administration.

Thirty-two children saw cessation of seizure within 5 minutes of buccal midazolam administration, yielding a rate of 46 percent. In comparison 41 patients in the intramuscular arm achieved the efficacy endpoint, with a rate of 61 percent. The absolute difference was of borderline significance (15.5 percent; p=0.07).

Moreover, the average time from medication administration to seizure cessation was marginally shorter in the intramuscular midazolam group (15.9±28.7 vs 17.8±27.5 minutes; p=0.69). Cox regression analysis showed that the duration of seizures after intramuscular vs buccal midazolam was 13 percent shorter, though significance was not achieved (p=0.49).

In terms of safety, one patient in the intramuscular arm developed respiratory depression and hypotension within 3 minutes of medication administration. Patient recovered fully with intervention and within 15 minutes after drug administration. Such an event was not observed in the buccal midazolam group.

“We conclude that the efficacy and safety of intramuscular midazolam as first-line treatment for paediatric seizures compares favourably to buccal midazolam,” researchers said.

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Most Read Articles
22 Jul 2020
A picosecond alexandrite laser (PSAL) appears to be superior to Q-switched alexandrite laser (QSAL) for the treatment of nevus of Ota, as shown by its better clinical results and fewer adverse events, according to a study.
Elvira Manzano, 6 days ago
The efficacy and cardiovascular (CV) safety of the SGLT2* inhibitor empagliflozin vs DPP-4** inhibitors and GLP-1*** receptor agonists in real-world patients were demonstrated in two interim analyses of the EMPRISE+ study presented at ADA 2020.
2 days ago
Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
Stephen Padilla, 6 days ago
Higher levels of plasma vitamin C, total and individual carotenoid biomarkers, and their composite biomarker score appear to reduce the incidence of type 2 diabetes (T2D), according to the results of a prospective case-cohort study in eight European countries.