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Comparative Study on the Efficacy of Intranasal Midazolam vs Intravenous Midazolam in Convulsing Neonates and Children

Abstract

To compare the efficacy of intranasal midazolam in relation to intravenous midazolam for control of seizures. To observe variability if any amongst the two groups in terms of heart rate, respiratory rate, blood pressure and oxygen saturation. A Prospective Randomized study conducted on 100 patients of 0-19 years of age hospitalized in emergency ward and NICU in a convulsing state. They were divided into two groups. GP-I was given intranasal midazolam @ 0.3 mg/ kg and GP-II was given intravenous midazolam @ 0.3 mg/ kg. Outcome was measured in terms of: Time taken from physician contact to drug administration. Time taken from drug administration to cessation of seizures. Mean time from physician contact to drug administration was significantly shorter with intranasal midazolam as compared to intravenous midazolam viz [ 0.40+ 0.10min vs 1.06+0.40+min) [p< 0.05 ].Mean time from drug administration to cessation of seizures was comparable in both the groups 1.0 + 0.31 min and 1.0+0.32 min (p> 0.05). However this difference was statistically insignificant. The readings for oxygen saturation and vital parameters did not show a statistically significant difference amongst the groups. Seizure control was more prompt with intranasal midazolam as compared to intravenous midazolam. As time needed for drug administration was lesser. Intranasal midazolam is a rapid, efficacious, easy to administer and socially more acceptable route of drug administration. It can be used not only in hospital setting but also for home management of seizures after proper instructions to parents.

Richa Sharma1, and Rekha Harish

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