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Arq Neuropsiquiatr. 2000 Jun;58(2A):282-7.  [Comparative non-randomized study with midazolam versus thiopental in children with refractory status epilepticus].  [Article in Portuguese]  Löhr A Jr, Werneck LC

We evaluated the use of midazolam versus thiopental in 50 children with refractory status epilepticus (RSE), admitted in a pediatric intensive care unit.  The study consisted of two groups of patients:

• Group A - Midazolam, a prospective study, and
• Group B - Thiopental, a historical group.

These patients already had previous medication with benzodiazepin and diphenylhydantoin and other drugs.

• When there was no effective control of the seizures, the patients of Group A received midazolam of 200 microg/kg intravenous in bolus, being followed by continuous intravenous infusion at the rate 0. 25-15 microg/kg/min.
• Group B received thiopental 1 mg/kg intravenous in bolus followed by continuous intravenous infusion at the rate of 10-120 microg/kg/min.

In relation to the time of seizure control and effectiveness, there was no statistical significance for the two groups. The Midazolam Group had significantly less complications during the treatment: less cyanosis (p=0.00006), and they did not need respiratory support (p<0.00001).

When the therapy with midazolam was ceased, 12.5% of the patients from this group showed psychological disorders such as mental confusion, aggressive behavior, restlessness, hallucinations and agitation.

PMID: 10849628