Premedication with midazolam in young children: a comparison of four routes of administration

Kogan, Alexander; Katz, Jacob; Efrat, Rachel; Eidelman, Leonid A.

doi:10.1046/j.1460-9592.2002.00918.x

Cited by 140 publications

(128 citation statements)

References 22 publications

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…It may be possible to reduce this effect by using a more concentrated form of midazolam. This has been shown to increase bioavailability as more absorption occurs transmucosally and less by the orogastric route, and therefore lower doses might be used [17].…”

Section: Discussionmentioning

confidence: 99%

The use of intranasal midazolam in the treatment of paediatric dental patients*

Gilchrist¹,

Cairns²,

Leitch³

2007

Anaesthesia

View full text Add to dashboard Cite

SummaryThe aim of this study was to assess the use of intranasal midazolam in paediatric dental patients requiring extractions or simple surgical procedures who may otherwise have required a general anaesthetic. Twenty children aged between 2–9 years who required simple surgical procedures were given 0.25 mg.kg−1 midazolam, administered using a MAD® (Mucosal Atomization Device; Wolfe Tory Medical Inc., Salt Lake City, UT, USA). Compliance with the full dose was achieved in 14 patients, 13 of whom completed the treatment. One of two patients who allowed only partial administration completed the treatment and three patients did not comply. The mean time to starting treatment was 13 min (range 6–25 min) and patients were discharged after a mean of 46 min (range 25–67 min). Physiological parameters remained stable throughout with no clinically significant episodes of desaturation. One patient vomited at home postoperatively. Midazolam in a dose of 0.25 mg.kg−1 administered intranasally provided adequate anxiolysis for the majority of children, allowing them to complete their treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

The use of intranasal midazolam in the treatment of paediatric dental patients*

Gilchrist¹,

Cairns²,

Leitch³

2007

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…190 Intranasal delivery, despite demonstrating more rapid onset of action, also may be less tolerated because of burning of the nasal mucosa during administration. 54,191 Drug delivery into the central nervous system is greatly enhanced with the use of an atomizer that distributes the medication more evenly to the mucous membranes. [192][193][194] Because adverse events are still possible when this mode of opiate administration is used, care should be taken when using adjunctive medications, such as benzodiazepines.…”

Section: Analgesia In the Ed And Ems Settingmentioning

confidence: 99%

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Zempsky¹,

Cravero²,

Shaw³

et al. 2012

Pediatrics

291

179

View full text Add to dashboard Cite

Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child' s and family' s reaction to current and future medical care. A systematic approach to pain management and anxiolysis, including staff education and protocol development, can provide comfort to children in the emergency setting and improve staff and family satisfaction. Pediatrics 2012;130:e1391-e1405 BACKGROUND A systematic approach to pain management is required to ensure relief of pain and anxiety for children who enter into the emergency medical system, which includes all emergency medical services (EMS) agencies, interfacility critical care transport teams, and the emergency department (ED). 1 The administration of appropriate analgesia in children varies by age as well as by training of the ED team (which includes physicians, nurses, physician assistants, and nurse practitioners), however, and still lags behind analgesia provided for adults in similar situations. 2 Furthermore, neonates are at highest risk of receiving inadequate analgesia. 3,4 Encouragingly, improvements in the recognition and treatment of pain in children have led to changes in the approach to pain management for acutely ill and injured pediatric patients. 5 Studies have shown an increase in opiate use in children with fractures. [6][7][8] Recent advances in the approach and support for pediatric analgesia and sedation, as well as new products and devices, have improved the overall climate of the ED for patients and families in search of the "ouchless" ED. 5,9 Increased parental education regarding pain and sedation, physician comfort and desire to enhance patient satisfaction, and a quest to satisfy accreditation regulations have appropriately driven this effort. System-wide approaches for pain management awareness and strategies work best if they are woven into the fabric of the emergency medical system through education and protocol development. The purpose of this report was to provide information to optimize the comfort and minimize the distress of children and families as they are cared for in the emergency setting.

show abstract

“…Preoperative anxiety is therefore an important concern for paediatric anaesthesiologists. 2 Many anxiolytic medications have been tried with varying results. Of the benzodiazepines, midazolam has become the most frequently used premedication 2,3 due to its fast onset and short duration of action.…”

Section: Introductionmentioning

confidence: 99%

Comparison of dexmedetomidine versus midazolam for intranasal premedication in children posted for elective surgery: a double-blind, randomised study

Singla¹,

Chaudhary²,

Dureja³

et al. 2015

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

Objective: The aim of this study was to compare the effect of dexmedetomidine with midazolam for intranasal premedication in children posted for elective surgery. Trial design: This was a prospective, randomised, double-blinded clinical study. Method: 60 children, 3 to 10 years of age, with American Society of Anaesthesiologists (ASA) physical status I, scheduled for elective surgery, were randomly divided into two groups, group D (dexmedetomidine) and group M (midazolam). Group D patients received intranasal dexmedetomidine 1 μg/kg and group M patients intranasal midazolam 0.2 mg/kg, approximately 30 minutes before induction of anaesthesia, in the form of a spray. Outcome: Preoperative effects on heart rate, blood pressure, sedation and anxiety including parental separation and mask acceptance were assessed. Results: Intranasal dexmedetomidine (1 μg/kg) premedication resulted in statistically significant but clinically unimportant lower heart rate and blood pressure at 10, 20, and 30 minutes following administration compared with intranasal midazolam (0.2 mg/kg). There were no episodes of hypotension or bradycardia. Children in group D achieved better parental separation and mask acceptance scores compared with group M. Conclusion: Dexmedetomidine resulted in better parental separation and mask acceptance scores than intranasal midazolam. Thus it would seem to offer some advantage compared with midazolam.

show abstract

Premedication with midazolam in young children: a comparison of four routes of administration

Abstract: Intranasal, oral, rectal and sublingual midazolam produces good levels of sedation and anxiolysis. Mask acceptance for inhalation induction was easy in the majority of children, irrespective of the route of drug administration.

Cited by 140 publications

References 22 publications

The use of intranasal midazolam in the treatment of paediatric dental patients*

The use of intranasal midazolam in the treatment of paediatric dental patients*

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Comparison of dexmedetomidine versus midazolam for intranasal premedication in children posted for elective surgery: a double-blind, randomised study

Contact Info

Product

Resources

About