Buccal route is an alternative for treating acute seizures in children
Buccal midazolam is more effective than rectal diazepam for treating acute seizures in children, a UK study has shown (Lancet 2005;366:205).
The trial, based at Alder Hey Children’s Hospital, Liverpool, Derbyshire
Children’s Hospital, Birmingham Children’s Hospital and Queen’s
Medical Centre, Nottingham, compared the treatments across 219 episodes
in 177 children aged over six months who presented to hospital with seizures
and could not be treated with intravenous drugs.
The therapeutic success rate, defined as cessation of seizure within
10 minutes of drug administration without either respiratory depression
or another seizure within an hour, was 56 per cent (61 of 109) for buccal
midazolam and 27 per cent (30 of 110) for rectal diazepam.
The authors explain that intravenous access is not always possible in
children having a seizure and that an effective and safe alternative
is frequently required. “Despite some initial reservations, anecdotal
comments from staff in [accident and emergency departments] suggest that
the buccal route was easy to use,” they add.
Use of the buccal route by non-trained carers in non-hospital situations
will, they say, be the topic for future work. |
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