title: Propofol versus thiopental sodium for the treatment of refractory status epilepticus (Review).
abstract: BACKGROUND
  Failure to respond to antiepileptic drugs in uncontrolled seizure activity such as refractory status epilepticus (RSE) has led to the use of anaesthetic drugs. Coma is induced with anaesthetic drugs to achieve complete control of seizure activity. Thiopental sodium and propofol are popularly used for this purpose. Both agents have been found to be effective. However, there is substantial lack of evidence as to which of the two drugs is better in terms of clinical outcome.
  
  
  OBJECTIVE
  To compare the efficacy, adverse effects, and short- and long-term outcomes of RSE treated with one of the two anaesthetic agents, thiopental sodium or propofol.
  
  
  METHODS
  We searched the Cochrane Epilepsy Group Specialized Register (10 May 2012), the Cochrane Central Register of Controlled Trials (CENTRAL Issue 4 of 12, The Cochrane Library 2012), and MEDLINE (1946 to May week 1, 2012). We also searched (10 May 2012) ClinicalTrials.gov, The South Asian Database of Controlled Clinical Trials, and IndMED (a bibliographic database of Indian Medical Journals).
  
  
  METHODS
  All randomised or quasi-randomised controlled studies (regardless of blinding) of control of RSE using either thiopental sodium or propofol.
  
  
  METHODS
  Two review authors screened the search results and reviewed abstracts of relevant and eligible trials before retrieving the full text publications.
  
  
  RESULTS
  One study was available for review. This study was a small, single-blind, multicentre trial studying adults with RSE and receiving either propofol or thiopental sodium for the control of seizure activity (Rossetti 2011). This study showed a wide confidence interval suggesting that the drugs may differ in efficacy up to more than two-fold. There was no evidence of a difference between the drugs with respect to the outcome measures such as control of seizure activity and functional outcome at three months.
  
  
  CONCLUSIONS
  There is lack of robust and randomised controlled evidence that can clarify the efficacy of propofol and thiopental sodium over each other in the treatment of RSE. There is a need for large, randomised controlled trials for this serious condition.
authors.affiliation: Department of Neuroanaesthesiology, All India Institute of Medical Sciences, New Delhi, India. prabhakaraiims@yahoo.co.in
authors.forename: Hemanshu
authors.initials: H
authors.lastname: Prabhakar
authors.forename: Ashish
authors.initials: A
authors.lastname: Bindra
authors.forename: Gyaninder Pal
authors.initials: GP
authors.lastname: Singh
authors.forename: Mani
authors.initials: M
authors.lastname: Kalaivani
mesh_terms: D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015742:Propofol / Q000008:administration & dosage* / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic; D013226:Status Epilepticus / Q000188:drug therapy*; D013874:Thiopental / Q000008:administration & dosage* / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D013874:Thiopental; D015742:Propofol
keywords: Adult; Anesthetics; Anticonvulsants [therapeutic use]; Humans; Intravenous [therapeutic use]; Propofol [therapeutic use]; Status Epilepticus [drug therapy]; Thiopental [therapeutic use]