The potential prehospital role of levetiracetam: a systematic review

Résumé fourni par la source

Background: Status epilepticus is a life-threatening, time-critical emergency associated with substantial mortality. Current treatment delivered by paramedics is the administration of benzodiazepines and working in critical care teams that deliver prehospital emergency anaesthesia. In hospitals, second-line agents are used before anaesthesia. Levetiracetam is a pharmacologically stable agent suitable for the prehospital environment. Methods: A systematic review of the literature on the use of levetiracetam in terminating acute status epilepticus was carried out. Prehospital studies were limited so in-hospital papers from emergency settings were included. Results: Levetiracetam has overall efficacy of 71.9% (95% CI (66.3–77.5)), comparable to phenytoin and sodium valproate. It has fewer adverse events than other agents. Response was independent of dose administered but higher doses (>40 mg/kg) caused more side effects. Conclusions: Levetiracetam is a safe, effective medication in terminating status epilepticus and may reduce the need for prehospital emergency anaesthesia if used in prehospital management. More research should be done in the prehospital setting.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.