Respiratory depression in the acute management of seizures

The incidence of respiratory depression following treatment of prolonged seizures with benzodiazepines is variable in the literature. We retrospectively reviewed the charts of children treated for prolonged seizure over a one year period. Of the 56 seizures treated, 30 received lorazepam, 19 diazepam, and seven both drugs. Twenty two episodes (39%) of prolonged seizure were treated with multiple doses of benzodiazepines. In eight events (14%), there was documented respiratory depression following the administration of one or more doses of benzodiazepine; in six of these, multiple doses were given. The doses used were often at the Iow end or less than the recommended dose for treatment of status epilepticus. These dato support suggestions that multiple doses of benzodiazepines increase the risk of respiratory depression.