The Efficacy And Safety Of Benzodiazepines Compared With Nonbenzodiazepines For The Patients Undergoing Status Epilepticus: A Meta-Analysis

Background:We performed a meta-analysis to assess the safety and efficacy of benzodiazepines (BZPs) versus nonbenzodiazepines (NBZPs) in patients with status epilepticus (SE).Methods:An electronic search was performed in using PubMed, Embase, and the Cochrane Library. We included randomized controlled trial (RCT) that compared NBZPs with BZPs in the treatment of SE. Our primary outcome was the proportion of patients presenting SE stopped by BZPs versus NBZPs. The safety endpoint was the events of death related to antiepileptic drug (AED) use, hypotension and respiratory depression. Results:This meta-analysis included 5 studies involving 919subjects. BZPs achieved seizure cessation more often than NBZPs (relative risk [RR]:1.17,95% confidence interval [CI]:1.04 to 1.31, P=0.009). Hypotension (RR:1.21; 95% CI:0.98-1.48, P=0.07), the events of death related to AED use (RR:0.90; 95% CI:0.55-1.47, P=0.68) did not appear to differ between BZPs and NBZPs. NBZPs excluding PB had significantly less respiratory depression than BZPs (RR:2.08,95% CI:1.25 to 3.47, P=0.005).Conclusions:Compared with NBZPs, BZPs can control SE more effectively, without significantly impacting the risk of hypotension and the event of death related to AED use. NBZPs excluding PB are the first choice to treat patients with serious diseases of respiratory system undergoing SE.