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'Risk of bias' graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.
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Figure 1

'Risk of bias' graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.

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Study flow diagram.
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Figure 2

Study flow diagram.

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Comparison 1 Propofol versus thiopental sodium, Outcome 1 Total control of seizures.
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Analysis 1.1

Comparison 1 Propofol versus thiopental sodium, Outcome 1 Total control of seizures.

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Comparison 1 Propofol versus thiopental sodium, Outcome 2 In‐hospital mortality.
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Analysis 1.2

Comparison 1 Propofol versus thiopental sodium, Outcome 2 In‐hospital mortality.

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Comparison 1 Propofol versus thiopental sodium, Outcome 3 Adverse events.
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Analysis 1.3

Comparison 1 Propofol versus thiopental sodium, Outcome 3 Adverse events.

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Study

Propofol group

Thiopentone sodium group

Rossetti 2011

Median: 4 days

Median: 17 days

Rossetti 2011

Range: 2 to 28 days

Range: 5 to 70 days

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Analysis 1.4

Comparison 1 Propofol versus thiopental sodium, Outcome 4 Duration of mechanical ventilation.

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Comparison 1 Propofol versus thiopental sodium, Outcome 5 Long‐term outcomes.
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Analysis 1.5

Comparison 1 Propofol versus thiopental sodium, Outcome 5 Long‐term outcomes.

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Summary of findings for the main comparison. Propofol compared to Thiopental sodium for the treatment of refractory status epilepticus

Propofol compared to Thiopental sodium for the treatment of refractory status epilepticus

Patient or population: patients with the treatment of refractory status epilepticus
Settings: Hospital based
Intervention: Propofol
Comparison: Thiopental sodium

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Thiopental sodium

Propofol

Total control of seizures

Study population

RR 1.5
(0.4 to 5.61)

21
(1 study)

⊕⊕⊝⊝
low1,2

286 per 1000

429 per 1000
(114 to 1000)

In‐hospital mortality

Study population

RR 1.5
(0.19 to 11.93)

21
(1 study)

⊕⊕⊝⊝
low1,2

143 per 1000

214 per 1000
(27 to 1000)

Length of intensive care unit (ICU) stay

Not reported

Not reported

NA

NA

NA

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Single blinded study: we downgraded one level for risk of bias
2 Wide confidence intervals crossing the line of "no effect" were noted; we downgraded one level for imprecision

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Summary of findings for the main comparison. Propofol compared to Thiopental sodium for the treatment of refractory status epilepticus
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Table 1. Overview of study populations

Study ID

Interventions

Screened (n)

Randomised (n)

Safety analysis (n)

ITT (n)

Finishing study (n)

[%] of randomised participants
finishing study

Rossetti 2011

I1 Propofol

I2 Barbiturate (thiopental (n = 7) and pentobarbital (n = 3))

I1 14

I2 10

I1 14

I2 10

I1 14

I2 10

I1 14

I2 10

I1 14

I2 9

I1 100

I2 90

I1: intervention 1; I2: intervention 2; ITT: intention‐to‐treat; n: number.
Figuras y tablas -
Table 1. Overview of study populations
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Table 2. Adverse effects

Characteristic

Rossetti 2011

I1

I2

Propofol

Thiopental

Participants who died (n)

Epilepsy‐related

I1 Propofol

I2 Thiopental

0

0

Participants who died (n)

All causes

I1 Propofol

I2 Thiopental

3

1

Adverse events (n)

I1 Propofol

I2 Thiopental

14

11

Serious adverse events (n)

I1 Propofol

I2 Thiopental

1

1

Duration of ICU stay

Not reported

Duration of mechanical ventilation (median (range))

I1 Propofol

I2 Thiopental

17 days (5 to 70 days)

4 days (2 to 28 days)

Duration of hospitalisation

Not reported

Neurological deficits

Not reported

Cognitive deficits

Not reported

Haematological toxicity

Not reported

Liver toxicity

Not reported

Hypersensitivity or drug allergy

Not reported

Bronchopneumonia

Not reported

Other side effects

Not reported

I1: intervention 1; I2: intervention 2; ICU: intensive care unit; n: number.
Figuras y tablas -
Table 2. Adverse effects
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Comparison 1. Propofol versus thiopental sodium

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Total control of seizures Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2 In‐hospital mortality Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3 Adverse events Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Infection

1

21

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.35, 1.41]

3.2 Hypotension

1

21

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.38, 2.00]

3.3 Other serious complications

1

21

Risk Ratio (M‐H, Fixed, 95% CI)

0.5 [0.04, 6.86]

4 Duration of mechanical ventilation Show forest plot

Other data

No numeric data

5 Long‐term outcomes Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Figuras y tablas -
Comparison 1. Propofol versus thiopental sodium
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