Anesthetics Versus Non-Anesthetics For The Treatment Of Refractory Status Epilepticus:a Meta Analysis

Objective The objective was to determine by systematic review if anesthetics is more effective than non-anesthetics in terminating refractory status epilepticus (RSE) seizures.Method We performed a search of PubMed, Medline, CNKI, Wanfang Database for studies about anesthetics and non-anesthetics for treatment of RSE published before March 2015. These studies must meet our preliminary selection criteria and were evaluated using the Newcastle-Ottawa Scale (NOS). Pick up the date of respons rate, the time of response to medicine, mechanical ventilation and staying in intensive care unit (ICU). The statistical analysis was conducted by using Review Manager 5.3.5.Results Six studies with 306 subjects were included. Anesthetics is as effective as non-anesthetics (P=0.14, OR=0.60,95%CI=0.30～1.17). Midazolam is as effective as non-anesthetics (P=0.07, OR=0.47, 95%CI=0.21～1.06). The time to response of Midazolam versus non-anesthetics is not significant difference (P=0.24, MD=9.13, 95%CI=-6.22-24.48). The time of mechanical ventilation of the group treating with anesthetics is shorter than the group treating with non-anesthetics(P=0.006, MD=-2.90,95%CI=-4.96--0.84) and the time of staying in ICU of the group treating with anesthetics is longer than the group treating with non-anesthetics(P< 0.00001, MD=8.40, 95%CI=5.93-10.87). The mortality of anesthetics group is higher than the non-anesthetics group (P<0.0001, OR=3.66,95%CI=1.91-7.04).Conclusion Anesthetics (Midazolam, propofol)is as effective as non-anesthetics(Diazepam, Valproate, Pentobarbital et al.). The time of respiratory depression of midazolam and propofol is shorter than non-anesthetics. While the time of staying in ICU treating with anesthetics is longer than the one treating with non-anesthetics, and with a higher risk of death.