Khan Arif, Baheerathan Aravindhan, Setty Gururaj, Hussain Nahin
Department of Paediatric Neurology, Leicester Royal Infirmary, University Hospitals of Leicester, Leicester, UK.
Acta Paediatr. 2014 Apr;103(4):e165-8. doi: 10.1111/apa.12529. Epub 2014 Jan 1.
Buccal midazolam has emerged as an effective alternative to rectal diazepam in the management of paediatric status epilepticus. This study aimed to identify carers' views on the safety, efficacy and acceptability of buccal midazolam in the management of this common neurological emergency.
Community-based, face-to-face interviews were carried out with 34 carers to evaluate the effectiveness, adverse effects and convenience of buccal midazolam as a rescue treatment for prolonged seizures. All children received 2.5 to 10 mg of Epistatus, a proprietary oral solution (10 mg/mL). We evaluated therapeutic success, time taken for seizures to cease and the need to attend the emergency department, together with the development of side effects, namely respiratory depression and sedation.
Most of the families (91%) found that buccal midazolam was always, or usually, effective in stopping seizures and it prevented hospital admission in 65% of cases. The majority (96%) of those who had used both buccal midazolam and rectal diazepam preferred the former as it was easier to administer, more socially acceptable and did not sedate the child as much.
Carers felt that buccal midazolam was an effective, safe and more acceptable alternative to rectal diazepam in the management of paediatric status epilepticus.
在小儿癫痫持续状态的治疗中，口腔咪达唑仑已成为直肠地西泮的一种有效替代药物。本研究旨在确定护理人员对口腔咪达唑仑治疗这种常见神经急症的安全性、有效性和可接受性的看法。
对34名护理人员进行基于社区的面对面访谈，以评估口腔咪达唑仑作为长时间癫痫发作抢救治疗的有效性、不良反应和便利性。所有儿童均接受2.5至10毫克的Epistatus（一种专利口服溶液，10毫克/毫升）。我们评估了治疗成功率、癫痫发作停止所需时间以及前往急诊科的必要性，以及副作用的发生情况，即呼吸抑制和镇静作用。
大多数家庭（91%）发现口腔咪达唑仑在终止癫痫发作方面总是或通常有效，并且在65%的病例中避免了住院治疗。大多数（96%）同时使用过口腔咪达唑仑和直肠地西泮的人更喜欢前者，因为它更容易给药，在社会上更易接受，并且对儿童的镇静作用较小。
护理人员认为，在小儿癫痫持续状态的治疗中，口腔咪达唑仑是直肠地西泮的一种有效、安全且更易接受的替代药物。
