Fişgin Tunç, Gurer Yavuz, Teziç Tahsin, Senbil Nesrin, Zorlu Pelin, Okuyaz Cetin, Akgün Deniz
Pediatric Neurology Department, Dr Sami Ulus Child Health and Disease Centre, Telsizler-Ankara, Turkey.
J Child Neurol. 2002 Feb;17(2):123-6. doi: 10.1177/088307380201700206.
In this study, the effects and side effects of rectal diazepam and intranasal midazolam were compared in the treatment of acute convulsions in children to develop a practical and safe treatment protocol. In the diazepam group, the seizures of 13 (60%) patients terminated in 10 minutes; however, 9 (40%) patients did not respond. In the midazolam group, 20 (87%) patients responded in 10 minutes, but 3 (13%) patients did not respond. Regarding the anticonvulsant effect, midazolam was found to be more effective than diazepam, and the difference was statistically significant (P < .05). The necessity of a second drug for the seizures that did not stop with the first drug was higher in the diazepam group than the midazolam group, and the difference was statistically significant (P < .05). We conclude that as an antiepileptic agent, intranasal midazolam is more effective than rectal diazepam. After administration, we did not observe any serious complications. Further investigations are necessary; however, intranasal administration is easy, so if the nasal drop and spray forms used in some European countries and the United States are available worldwide, it will be very useful for physicians in the emergency room.
在本研究中，比较了直肠给予地西泮和鼻内给予咪达唑仑治疗儿童急性惊厥的效果及副作用，以制定切实可行且安全的治疗方案。在地西泮组中，13例（60%）患者的惊厥在10分钟内终止；然而，9例（40%）患者无反应。在咪达唑仑组中，20例（87%）患者在10分钟内有反应，但3例（13%）患者无反应。关于抗惊厥效果，发现咪达唑仑比地西泮更有效，差异具有统计学意义（P < .05）。地西泮组中首次用药后惊厥未停止而需要使用第二种药物的必要性高于咪达唑仑组，差异具有统计学意义（P < .05）。我们得出结论，作为一种抗癫痫药物，鼻内给予咪达唑仑比直肠给予地西泮更有效。给药后，我们未观察到任何严重并发症。尽管还需要进一步研究；然而，鼻内给药操作简便，所以如果在欧洲一些国家和美国使用的滴鼻剂和喷雾剂形式能在全球范围内普及，这对急诊室的医生将非常有用。
