Aldharman Sarah S, Alayed Faisal T, Almutairi Fay A, Aljohani Badr S, Alhumaidi Kadi A, Alayyaf Abdulaziz S, Alismail Rayan M, Binshalhoub Fahad H, Alsahil Shahad J, Alnaaim Saud A
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.
Cureus. 2023 Apr 27;15(4):e38212. doi: 10.7759/cureus.38212. eCollection 2023 Apr.
Status epilepticus is a neurological emergency associated with high morbidity and mortality with fatal outcomes if not treated well. The goal of this study was to compare the intramuscular and intravenous treatment of individuals with status epilepticus. A search was performed on Scopus, PubMed, Embase, and Web of Science databases for articles published in the English language in peer-reviewed publications up to March 1, 2023. Studies were included if the treatment of status epileptics was compared either directly or indirectly between intramuscular and intravenous methods. In addition, relevant papers were manually screened for in the reference lists of the included studies. Non-duplicate articles were identified. Finally, five articles were included in the analysis, of which four were randomized controlled trials and one was a retrospective cohort study. The intramuscular midazolam group's time until the first seizure stopped was significantly shorter than the intravenous diazepam group's time (7.8 versus 11.2 minutes, respectively; p = 0.047). Moreover, the percentage of patients admitted was significantly lower in the intramuscular group than in the intravenous group (p = 0.01), but the lengths of stay in the intensive care unit and the hospital did not differ significantly between the groups. Regarding seizure recurrence, the intramuscular group had fewer incidences of recurrent seizures. Finally, there were no appreciable differences in safety outcomes between the two treatment arms. During the analysis, different outcomes reported after the use of intramuscular and intravenous treatments in managing patients with status epilepticus were categorized. This categorization led to a clear view of the efficacy and safety of intramuscular versus intravenous treatments in managing status epilepticus patients. The information at hand indicates that intramuscular therapy is just as successful as intravenous therapy in treating people with status epilepticus. The availability, adverse effect profile, logistics of administration, cost, and whether it is included in hospital formularies are some of the factors to be taken into consideration when choosing the drug administration technique.
癫痫持续状态是一种神经急症，具有高发病率和死亡率，若治疗不当会导致致命后果。本研究的目的是比较癫痫持续状态患者的肌肉注射和静脉注射治疗。对Scopus、PubMed、Embase和Web of Science数据库进行检索，以查找截至2023年3月1日在同行评审出版物中发表的英文文章。如果直接或间接比较了癫痫持续状态患者肌肉注射和静脉注射方法的治疗情况，则纳入研究。此外，对纳入研究的参考文献列表进行人工筛选以查找相关论文。识别出非重复文章。最后，五项文章被纳入分析，其中四项为随机对照试验，一项为回顾性队列研究。肌肉注射咪达唑仑组首次癫痫发作停止的时间显著短于静脉注射地西泮组的时间（分别为7.8分钟和11.2分钟；p = 0.047）。此外，肌肉注射组入院患者的百分比显著低于静脉注射组（p = 0.01），但两组在重症监护病房和医院的住院时间没有显著差异。关于癫痫复发，肌肉注射组癫痫复发的发生率较低。最后，两个治疗组在安全性结果方面没有明显差异。在分析过程中，对肌肉注射和静脉注射治疗癫痫持续状态患者后报告的不同结果进行了分类。这种分类使人们清楚地了解了肌肉注射与静脉注射治疗癫痫持续状态患者的疗效和安全性。现有信息表明，肌肉注射疗法在治疗癫痫持续状态患者方面与静脉注射疗法同样成功。在选择药物给药技术时，可及性、不良反应谱、给药后勤、成本以及是否列入医院处方集等都是需要考虑的因素。
