Review of the efficacy of rectal paraldehyde in the management of acute and prolonged tonic-clonic convulsions
| Autor: | Andrew Rowland, A. Al Kharusi, A. B. Stewart, C. Cramp, Richard Appleton, L.-K. Yeung, A. M. Gill |
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| Rok vydání: | 2009 |
| Předmět: |
Adolescent
Paraldehyde Status epilepticus Neurological disorder Drug Administration Schedule Epilepsy Administration Rectal Convulsion medicine Humans Prospective Studies Child Prospective cohort study Depression (differential diagnoses) Medical Audit business.industry Seizure types Infant medicine.disease Treatment Outcome Child Preschool Anesthesia Acute Disease Pediatrics Perinatology and Child Health Anticonvulsants Epilepsy Tonic-Clonic Safety medicine.symptom business medicine.drug |
| Zdroj: | Archives of Disease in Childhood. 94:720-723 |
| ISSN: | 1468-2044 0003-9888 |
| Popis: | Introduction: The aim of this prospective audit was to assess the effectiveness and safety of rectal paraldehyde in the management of acute, including prolonged, tonic-clonic convulsions. There are very limited published data on its effectiveness and safety and previous data have focused on its intramuscular route of administration. Methods: Four hospitals participated in the study. Information was collected on each dose of paraldehyde used for the treatment of a tonic-clonic convulsion over one year. Data were not included on patients treated with rectal paraldehyde for other seizure types or non-convulsive status epilepticus. Results: Data analysis was undertaken in 53 episodes in 30 patients. Patient’s ages ranged from 5 months to 16 years (mean 6.12 years and median 5.91 years). A pre-existing diagnosis of epilepsy was recorded in 35 episodes (66%). The mean dose of paraldehyde was 0.65ml/kg (standard deviation 0.22 ml/kg, 95% confidence interval +/- 0.06ml/kg) and median dose 0.79ml/kg. Rectal paraldehyde terminated the convulsion in 33 (62.3%) of the 53 episodes. In the 35 episodes where a pre-existing diagnosis of epilepsy was recorded, paraldehyde stopped the convulsion on 26 (74.3%) occasions. There was no difference in the dose of paraldehyde between the episodes where the convulsion was or was not terminated. There was no recorded respiratory depression in any episode. Conclusions: This study provides unique evidence that supports the belief that rectal paraldehyde is effective and safe in treating acute prolonged tonic-clonic convulsions. This would appear to confirm that paraldehyde should remain a treatment for the management of prolonged tonic-clonic convulsions, including convulsive status epilepticus. |
| Databáze: | OpenAIRE |
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