Comparison of Efficacy of Intranasal Midazolam and Conventional Treatment with Intravenous Diazepam for Control of Seizures in Children; A Randomized Controlled Trial

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Objective: To compare the efficacy of intranasal midazolam and conventional treatment with intravenous diazepam for the control of seizures in children. Methodology: It was a randomized controlled trial conducted in the Children Hospital, PIMS, Islamabad from January 2022 to June 2022 presenting to the ER department with seizures. The patients were randomly divided into two groups. Group A patients were given a single dose of intranasal midazolam (0.2 mg/kg).Group B patients were treated with a single dose of intravenous Diazepam (0.2mg/kg). We recorded the following parameters: 1) the period elapsed between arrival at emergency and drug administration. 2) The time interval between drug administration and cessation of seizures. 3) The period between admission to the hospital and the end of seizures. Results: Among 60 enrolled patients, there were thirty-one males and twenty-nine females. The mean age of the patient was 5.27 ± 3.31 years. The mean intervals between arrival at the hospital and treatment given were 3.00±0.91 and 7.03±2.91 mins (p-value 0.000) in groups A and B, respectively. The mean intervals between the treatment given and cessation of seizure were 2.70 ± 1.05 and 2.60 ± 1.13 mins (p-value 0.725) in groups A and B, respectively. The mean intervals between arrival at the hospital and the cessation of seizure were 5.70 ± 1.3 and 9.63 ± 2.58 mins (p-value 0.000) in groups A and B, respectively. Conclusion: The intranasal Midazolam was shown to be as effective in suppressing seizure as the intravenous Diazepam. This is the best option if you don't have access to an intravenous line.