Nasal Versus Venous Lorazepam for Control of Acute Seizures in Children (INLOR)
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Purpose
Status epilepticus (SE) is a common pediatric emergency which is potentially life-threatening and requires rapid termination. Early and effective treatment is essential to prevent the morbidity and mortality associated with prolonged convulsive SE. Lorazepam is the standard of care for control of SE when administered by intra-venous (IV) route. The investigators intend to compare efficacy and adverse effect profile of intra-nasal vs. intravenous routes of administration of lorazepam. In resource poor settings, sometimes trained personnel or appropriate equipment for intra-venous cannulation is not available. Alternate routes of administration, if shown equivalent to conventional IV route, will be very useful in such settings or for out of hospital management of seizures in children.
| Condition | Intervention | Phase |
|---|---|---|
|
Status Epilepticus Seizures |
Drug: Lorazepam |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Intra-Nasal vs. Intra-Venous Lorazepam for Control of Acute Seizures in Children: Prospective Open Labeled Randomized Equivalence Trial |
- Cessation of all clinical seizure activity within 10 min of drug administration [ Time Frame: 10 min ] [ Designated as safety issue: No ]
- Persistent cessation of seizure activity for 1 hr [ Time Frame: 1 hr ] [ Designated as safety issue: No ]
- Patients requiring rescue medication within 1 hr [ Time Frame: 1 hr ] [ Designated as safety issue: No ]
- Time to achieve intra-venous access after arrival in casualty [ Time Frame: minutes ] [ Designated as safety issue: No ]
- Time from drug administration to termination of seizure(s) [ Time Frame: minutes ] [ Designated as safety issue: No ]
- Development of hypotension (fall of >/= 20 mmHg systolic and/ or >/= 10 mmHg diastolic pressure) within 1 hr of drug administration [ Time Frame: 1 hr ] [ Designated as safety issue: Yes ]
- Development of significant respiratory depression requiring assisted ventilation [ Time Frame: 1 hr ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 140 |
| Study Start Date: | May 2008 |
| Study Completion Date: | April 2009 |
| Primary Completion Date: | April 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Intra-nasal lorazepam 0.1 mg/kg (max 4 mg)
|
Drug: Lorazepam
Intra-nasal 0.1 mg/kg (maximum 4 mg) once
|
|
Active Comparator: 2
Intra-venous lorazepam 0.1 mg/kg (max 4 mg)
|
Drug: Lorazepam
Intra-venous 0.1 mg/kg (maximum 4 mg) once
|
Eligibility| Ages Eligible for Study: | 6 Years to 14 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Children presenting convulsing to the pediatric emergency or developing seizure while in casualty
- Age 6-14 years
Exclusion Criteria:
- Known hypersensitivity to any benzodiazepine
- Child has received any parenteral anti-convulsant within 1 hr prior to enrollment
- Presence of severe cardio-respiratory compromise or cardiac arrhythmias
- Presence of upper respiratory tract infection
- Presence of basal skull fracture causing cerebro-spinal fluid (CSF) rhinorrhea
Contacts and Locations
More Information
No publications provided by All India Institute of Medical Sciences, New Delhi
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Ravindra Arya, All India Institute of Medical Sciences |
| ClinicalTrials.gov Identifier: | NCT00735527 History of Changes |
| Other Study ID Numbers: | INLOR |
| Study First Received: | August 12, 2008 |
| Last Updated: | May 4, 2009 |
| Health Authority: | India: Ministry of Health |
Keywords provided by All India Institute of Medical Sciences, New Delhi:
|
seizures status epilepticus lorazepam intra-nasal |
Additional relevant MeSH terms:
|
Seizures Status Epilepticus Epilepsy Brain Diseases Central Nervous System Diseases Nervous System Diseases Neurologic Manifestations Signs and Symptoms Lorazepam Anticonvulsants Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Hypnotics and Sedatives |
Central Nervous System Depressants Physiological Effects of Drugs Anti-Anxiety Agents Tranquilizing Agents Psychotropic Drugs GABA Modulators GABA Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Antiemetics Autonomic Agents Peripheral Nervous System Agents Gastrointestinal Agents |
ClinicalTrials.gov processed this record on May 21, 2013