Midazolam as a sole sedative for computed tomography imaging in pediatric patients

Abstract

The level of sedation achieved in children with midazolam 0.2 mg x kg(-1) is adequate for imaging with minimal side effects, no airway complications, and fast recovery. It can be recommended as the sole agent for sedation in pediatric patients for CT imaging.

Intramuscular Midazolam for Pediatric Sedation in the Emergency Department: A Short Communication on Clinical Safety and Effectiveness

“…Midazolam IM for temporary short-term pediatric sedation was safe and effective; the greatest sedative impact occurred 45 minutes after injection consistent with other investigations (3, 5, 6). Demographic characteristics such as age were not influential on the alteration of vital signs.…”

“…Various sedatives such as pentobarbital, propofol, fentanyl, ketamine and methohexital have been suggested for pediatric sedation but it seems that the selection of sedative agents was based on preference(2). The literature has little documentation on midazolam safety and efficacy in pediatric emergency departments; but there is an increasing interest to use midazolam for pediatric sedation and analgesia(3). We used intra-muscular (IM) midazolam to provide sedation for imaging in ED and then evaluated the efficacy and safety of midazolam for sedation and anxiety of children in the ED.…”

Intramuscular compared to intravenous midazolam for paediatric sedation: A study on cardiopulmonary safety and effectiveness

“…The reported side-effects also were not similar to those of the present study; decline of blood oxygen saturation was observed in 9.11%, hiccup in 1.38%, and agitation in 0.79%, which are absolutely different from results of the current research and the differences could be resulted of different brands of the medications used in two studies. [23] It was shown in another research by Cheuk et al in Hong Kong that psychological complications such as hallucination in 8.7% of cases were observed with IV administration of midazolam for paediatric sedation along with ketamine, which is different with the current research results in terms of occurrence percentage. [24] In one of the rare similar study by Kaufman et al, they illustrated that midazolam as an intranasal or bolus IV sedative agent could be effective, but similar efficacy with continues form of IV administration was obtained in higher dose.…”

Pediatric Procedural Sedation and Analgesia

“…Other side effects noted with midazolam, in decreasing order of frequency, include oxygen desaturation, apnea, hypotension, and hiccups. 42,43 With coadministration with opioids there is risk of hypoxia and apnea that is greater than with either agent used alone. Flumazenil is a benzodiazepine antagonist that can be used when iatrogenic overdose has occurred or when undesired effects occur.…”