[Comparative non-randomized study with midazolam versus thiopental in children with refractory status epilepticus].
We evaluated the use of midazolam versus thiopental in 50 children with refractory status epilepticus (RSE), admitted in a pediatric intensive care unit. The study consisted of two groups of patients: Group A - Midazolam, a prospective study, and Group B - Thiopental, a historical group. These patients already had previous medication with benzodiazepin and diphenylhydantoin and other drugs. When there was no effective control of the seizures, the patients of Group A received midazolam of 200 microg/kg intravenous in bolus, being followed by continuous intravenous infusion at the rate 0. 25-15 microg/kg/min. Group B received thiopental 1 mg/kg intravenous in bolus followed by continuous intravenous infusion at the rate of 10-120 microg/kg/min. In relation to the time of seizure control and effectiveness, there was no statistical significance for the two groups. The Midazolam Group had significantly less complications during the treatment: less cyanosis (p=0.00006), and they did not need respiratory support (p<0.00001). When the therapy with midazolam was ceased, 12.5% of the patients from this group showed psychological disorders such as mental confusion, aggressive behavior, restlessness, hallucinations and agitation.
Löhr
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Centro de Ciênicas Biológicas e da Saúde, Pontifícia Universidade Católica do Paraná. fredd@rla01.pucpr.br
Werneck
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LC
D000293:Adolescent; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013226:Status Epilepticus / Q000188:drug therapy*; D013874:Thiopental / Q000008:administration & dosage / Q000627:therapeutic use*
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D013874:Thiopental; D008874:Midazolam
Estudo comparativo não randomizado do midazolam versus thiopental em crianças com estado de mal epiléptico refratário.