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. 2020 Oct 7;20(4):168-174.
doi: 10.4103/2452-2473.297461. eCollection 2020 Oct-Dec.

Intranasal midazolam sedation as an effective sedation route in pediatric patients for radiologic imaging in the emergency ward: A single-blind randomized trial

Masoud Mayel  1 , Mehdi Ahmadi Nejad  2 , Mehdi Sadeghi Khabaz  1 , Maliheh Sadat Bazrafshani  3 , Ehsan Mohajeri  4
Affiliations

Intranasal midazolam sedation as an effective sedation route in pediatric patients for radiologic imaging in the emergency ward: A single-blind randomized trial

Masoud Mayel et al. Turk J Emerg Med. .

Abstract

Objectives: Prevention and reduction of pain, anxiety, and fear during medical procedures is one of the most important factors that should be considered in pediatric emergencies. The aim of this study was to compare the efficacy of oral versus intranasal midazolam in sedation during radiologic imaging in the largest province of Iran, Kerman.

Materials and methods: Eighty children were enrolled in this single-blind clinical trial based on convenience sampling and were divided into two groups receiving 0.5 mg/kg midazolam in oral route administration and 0.2 mg/kg midazolam in intranasal route administration. Finally, 75 patients remained for evaluating medication acceptability, sedation level, onset time of sedation, additional sedative dose, adverse effects of sedation, and provider satisfaction.

Results: Children in the intranasal group accepted medication more easily (89.8% vs. 36.9%; P ≤ 0.001), while these children received a lower sedation dose, but the sedation level in both methods was similar (P = 0.72). Our findings showed that children in the intranasal sedation group had a faster onset of sedation compared to the oral group (17.94 ± 8.99 vs. 34.50 ± 11.45; P ≤ 0.001). The frequency of midazolam side effects had no difference between the groups (29.7% vs. 15.8%; P = 0.15).

Conclusion: Intranasal midazolam with a lower sedation dose induces a faster onset and better acceptance. Intranasal midazolam can be used as an effective sedative method for pediatric patients, especially in emergency wards.

Keywords: Emergency ward; intranasal; midazolam; radiologic imaging.

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Conflict of interest statement

Conflicts of interest None Declared.

Figures

Figure 1
Figure 1
Flow diagram of progress through the phases of assessment of intranasal midazolam for sedation among pediatric patients
Figure 2
Figure 2
Comparison of sedation onset between the oral and intranasal groups
See this image and copyright information in PMC

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References

    1. Khatavkar SS, Bakhshi RG. Comparison of nasal Midazolam with Ketamine versus nasal Midazolam as a premedication in children. Saudi J Anaesth. 2014;8:17–21. - PMC - PubMed
    1. Khoshrang H, Haddadi S, Farzi F, Ebrahimpour N. Comparing the effect of premedication with intra-nasal Dexmedetomidine and intra-nasal Midazolam on sedation and anxiety level in children undergoing elective surgery. J Anesthesiol Pain. 2016;6:1–10.
    1. Pacifici GM. Clinical pharmacology of midazolam in neonates and children: Effect of disease-a review. Int J Pediatr. 2014;2014:309342. - PMC - PubMed
    1. Ayatollahi B, Behdad S. Evaluation of nasal Midazolam as a premedication anesthetic in preschool children. J Shahid Sadoughi Univ Med Sci. 2005;13:3–7.
    1. Hadley G, Maconochie I, Jackson A. A survey of intranasal medication use in the paediatric emergency setting in England and Wales. Emerg Med J. 2010;27:553–4. - PubMed