Comparison of intranasal versus intravenous midazolam for management of status epilepticus in dogs: A multi‐center randomized parallel group clinical study

• DOI: 10.1111/jvim.15627
• Publication Date: 2019-10-03T13:03:19Z
• Authors: Marios Charalambous; Holger A. Volk; Andrea Tipold; Johannes Erath; Enrice Huenerfauth; Antonella Gallucci; Gualtiero Gandini; Daisuke Hasegawa; Theresa Pancotto; John H. Rossmeisl; Simon Platt; Luisa De Risio; Joan R. Coates; Mihai Musteata; Federica Tirrito; Francesca Cozzi; Laura Porcarelli; Daniele Corlazzoli; Rodolfo Cappello; An Vanhaesebrouck; Bart J.G. Broeckx; Luc Van Ham; Sofie F.M. Bhatti
• Keywords: Midazolam

Abstract Background The intranasal (IN) route for rapid drug administration in patients with brain disorders, including status epilepticus, has been investigated. Status epilepticus is an emergency, and the IN offers a valuable alternative to other routes, especially when these fail. Objectives To compare versus IV midazolam (MDZ) at same dosage (0.2 mg/kg) controlling dogs. Animals Client‐owned dogs (n = 44) idiopathic epilepsy, structural or epilepsy of unknown origin manifesting as epilepticus. Methods Randomized parallel group clinical trial. Patients were randomly allocated IN‐MDZ 21) IV‐MDZ 23) group. Number successfully treated cases (defined seizure cessation within 5 minutes lasting ≥10 minutes), time, adverse effects recorded. Comparisons performed using Fisher's exact Wilcoxon rank sum tests statistical significance set α < .05. Results stopped 76% 61% cases, respectively ( P .34). median time was 33 64 seconds IV‐MDZ, .63). When place catheter taken into account, (100 seconds) superior .04) (270 seconds). Sedation ataxia seen 88% 79% respectively. Conclusions Clinical Importance Both routes are quick, safe, effective However, demonstrated superiority needed account.