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Previous issue date: 2011-12-21 / Objective : compare the therapeutic efficacy of intramuscular midazolam (IM-MDZ) and intravenous diazepam (IV-DZP) to 529treat seizures in children.Methods : Randomized controlled study enrolling children (2months-14years) presenting seizures admitted to the Pediatric Emergency Department of the Hospital Universit?rio de Santa Maria between August 2010-August 2011; being randomized to receive IV-DZP or IM-MDZ as initial treatment. The groups were compared regarding the length of time to start medication, to interrupt seizures after being medicated and the total length of time to achieve the seizures interruption.Results : Venous access was not obtained in 4 minutes in 4 patients (20%) assigned to the IV-DZP. 32 children completed the study (16 in each group). IV-DZP compared to the IM-MDZ, presented the longest interval to cease seizures (10.6 x 7.3min; p=0.006). Two children of each group (12.5%) the seizures did not stop after 10 minutes, being 3 children transferred to the PICU after tracheal intubation: 1 belonging to the IM-MDZ (6.25%0 and 2 in the IV-DZP group (12.5%). There were not differences regarding adverse effects between the groups (p=0.171): one child in the IM-MDZ presented hypotension (6.3%) and 5 (31%) presented hyperactivity or vomit after receiving IV-DZP.Conclusion : Intramuscular midazolam presented lower interval to cease seizures than IV diazepam. Intrauscular midazolam demonstrate be ans excellent o treat seizures in children as a result of its efficacy, facility and fast administration. / Objetivo : Comparar a efic?cia terap?utica da administra??o de Midazolam Intramuscular (MZ-IM) e do Diazepam Endovenoso (DZP-EV) em crian?as com crise convulsiva.M?todo : Estudo randomizado e controlado, envolvendo crian?as com crise convulsiva (2 meses a 14 anos) admitidas ao servi?o de Emerg?ncia do Hospital Universit?rio de Santa Maria no per?odo de agosto de 2010 a agosto 2011, sendo randomizadas a receber DZP-EV ou MZ-IM como tratamento inicial para convuls?es. Os grupos foram comparados em rela??o ao tempos necess?rio para iniciar a medica??o, para ceder a crise ap?s a administra??o do f?rmaco e o tempo total para ceder a crise.Resultados : N?o foi obtido acesso venoso aos 4 minutos em 4 pacientes (20%) assinalados ao grupo DZP-EV. Resultaram 32 crian?as que completaram o estudo (16 em cada grupo). O DZP-EV apresentou tempo total maior para ceder ? crise convulsiva quando comparado ao MZ-IM (10,6 x 7,3 min; p=0,006). Em 2 crian?as de cada grupo (12,5%) a crise n?o cedeu ap?s 10 minutos de tratamento, 3 crian?as foram transferidos para a UTI pedi?trica, ap?s serem intubadas: 1 (6,25%) do grupo MDZ-IM e 2 (12,5%) do DZP-EV. N?o houve diferen?a quanto a efeitos adversos entre os grupos (p=0,171): uma crian?a (6,3%) apresentou (hipotens?o) ap?s receber MDZ-IM e outras cinco crian?as (31%) apresentaram (hiperatividade ou vomito) ap?s receberem DZP-EV.Conclus?o : Midazolam intramuscular apresentou menor tempo total para ceder a crise convulsiva que o diazepam endovenoso. Midazolam intramuscular mostrou ser excelente op??o no tratamento de crises convulsivas na inf?ncia pela efic?cia, facilidade e rapidez de aplica??o.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1380 |
| Date | 21 December 2011 |
| Creators | Portela, Janete de Lourdes |
| Contributors | Piva, Jefferson Pedro |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a, PUCRS, BR, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 3098206005268432148, 500, 600, -8624664729441623247 |
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