Abstracts

Rationale: Status epilepticus (SE) is a condition of seizures with a very high mortality and disability rate. If patients are not treated within the first hour, they will turn to refractory status epilepticus (RSE). Currently, the RSE treatment guidelines recommend propofol as an alternative treatment which is effective but needs to be taken in high doses that can lead to propofol related infusion syndrome (PRIS). This study aimed to understand efficacy and safety of propofol in treatment of RSE including factors affecting efficacy and safety of propofol in seizure control. Methods: The retrospective study reviewed RSE patient records who received and did not receive propofol at Phramongkutklao Hospital from January 1, 2007 - December 31, 2018.  Results: There were 18 patients who received propofol [case group] and 37 patients who did not receive propofol [midazolam group]. The mortality rate of case group was 72.22% and midazolam group was 54.05% (p-value = 0.197). Clinical seizure suppression was 72.22% and 78.38%, respectively (p-value = 0.279). Electrographic seizure suppression was 55.56% and 54.05%, respectively (p-value = 0.476). Researchers did not find factors affecting efficacy and safety of propofol. Propofol related infusion syndrome (PRIS) was found at 88.89%. The commonest PRIS symptoms were metabolic acidosis (68.75%) and abnormal EKG (56.25%). Conclusions: The efficacy of propofol was comparable to those who did not receive it. However, there was a high incident rate of PRIS. Funding: No funding