Comparison between rectal administration of diazepam in solution and intravenous administration for management of convulsive disorders in infants and children

In order to compare rectal and intravenous(IV) administration of diazepam for management of convulsions,a prospective cross-sectional case-control study was conducted on 94 convulsive infants and children referring to the Emergency department of the university hospital No.1 in Kerman.all children were randomly divided into two groups.the patients were matched with regard to the cause,type,duration of the seizure and age.in group receiving rectal administration 46 patients received 0.5 mg/kg diazepam in solution using a lubricated insulin syring without the needle and in IV administration group,48 patients received diazepam at the dose of 0.2-0.3mg/kg through the peripheral veins,in group receiving rectal administration a single dose of diszepam solution was effective in stopping seizure in 37 patients(80.4%).in IV administration group,although IV access failed in 11 cases(23%) 33 out of 37 patients (98%) responded to a single dose of IV diazepam.the difference between IV and rectal administration of diazepam in control of seizure was statistically significant(p=0.04)more than half of the patients who were resistant to the rectal route did not respond to IV route either.the response latency for rectal administration was 3.3+_1 minutes and for IV administration was 2.78+_0.93(p=0.03).it is concluded that,although IV administration of diazepam is the method of choice for acute management of convulsive disorders,when IV access is impossible the best alternative is rectal administration of diazepam in solution.