| Objectives To compare the efficacy and safety of intramuscular(im)midazolam versus per rectum(pr)chloral hydrate in the prehospital treatment of acute convulsion in children in order to seek a safe and effective therapy for pediatric convulsion in the prehospital setting.Methods From Jun.2015 to May 2018 in the First Hospital of Qinhuangdao,the clinical data of 94 children with convulsion requiring treatment in the prehospital setting were collected and retrospectively analyzed.All patients were randomly divided into the midazolam group(group M,n=48)and the chloral hydrate group(group C,n=46)according to control measures for convulsion.On the basis of the conventional prehospital treatment,group M were treated with 0.2 mg/kg im midazolam,while group C were treated with 0.5 ml/kg pr chloral hydrate.The clinical efficacy and adverse reactions were compared.Results 1 No significant differences in effective rate and convulsion control time were found between two groups [93.8% vs.91.3%,(3.21±1.97)min vs.(3.57±2.12)min,P>0.05];There were no significant differences in the control cases of 1 min,3 min,5 min and 10 min between two groups(5 vs.4,24 vs.19,38 vs.34,45 vs.42,P>0.05);2 There was highly significant difference in start treatment time between group M and group C [(1.06±0.25)min vs.(1.62±0.34)min,P<0.01].The total time of convulsion remission in group M was significantly shorter than that in group C [(4.25±2.14)min vs.(5.21±2.08)min,P<0.05].3 Recurrent cases and the number of cases requiring maintenance treatment were significantly less in group M than those in group C(5 vs.12,8 vs.16,P>0.05);4 After intravenous maintenance treatment,convulsion control time in group M was less than that in group C [(32.63±14.42)min vs.(45.44±13.34)min,P<0.05],but no significant differences were noted in consciousness recovery time and hospital stay between group M and group C [(7.75±2.56)h vs.(8.39±2.19)h,(4.75±1.16)d vs.(5.06±1.12)d,P>0.05];5 There were no significant differences in systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),respiration(R),and blood oxygen saturation(Sp O2)between two groups before treatment(P>0.05).There was no significant difference in DBP before and after treatment in group C(P>0.05),while after treatment,SBP,HR,R of two groups and DBP of group M were lower as compared with before treatment(P<0.05).Fluctuations were within normal range and do not require discontinuation or treatment.Significant differences were not noted in SBP,DBP,HR,and R after treatment between both groups(P>0.05).Sp O2 in both groups after treatment were higher as compared with before treatment,reaching normal level,the differences in Sp O2 before and after treatment within each group were significant(P<0.05),but the difference between group M and group C was not significant(P>0.05);6 There were no obvious adverse reactions in both groups.Conclusions Im midazolam versus pr chloral hydrate are equally safe and effective for controlling pediatric convulsion in the prehospital setting.However,im midazolam has more convenient operation,higher stability,and is more suitable for pre-hospital first aid.Figure0;Table10;Reference 165... |
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