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Incidence and therapy of midazolam induced hiccups in paediatric anaesthesia

P Marhofer1, C Glaser, C G Krenn

  • 1Department of Anaesthesiology, University of Vienna, Vienna, Austria.

Paediatric Anaesthesia
|July 20, 1999
PubMed

Insights

Hiccups after rectal midazolam in children are common in younger patients but not dose-dependent. Intranasal ethyl chloride spray effectively treated these hiccups in pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Pharmacology

Background:

  • Rectal midazolam is frequently used for pediatric premedication.
  • Hiccups are a potential side effect of midazolam administration.
  • Effective treatment for midazolam-induced hiccups in children is needed.

Purpose of the Study:

  • To determine the incidence of hiccups in children receiving rectal midazolam.
  • To investigate the dose and age dependence of midazolam-induced hiccups.
  • To evaluate the efficacy of intranasal ethyl chloride spray for treating these hiccups.

Main Methods:

  • Prospective, randomized, double-blind study.
  • 200 pediatric patients (ASA physical status 1-2) received either 0.5 mg/kg or 1.0 mg/kg rectal midazolam.
  • Hiccups were treated with intranasal ethyl chloride spray if persistent.

Main Results:

  • Hiccup incidence was 22% (0.5 mg/kg) and 26% (1.0 mg/kg), not dose-dependent.
  • Hiccups were significantly more common in younger children (mean age 5-6 months) compared to older children (mean age 20-21 months).
  • Intranasal ethyl chloride spray achieved 100% success in treating hiccups.

Conclusions:

  • Rectal midazolam can induce hiccups in pediatric patients.
  • The incidence of midazolam-induced hiccups is significantly associated with younger age.
  • Intranasal ethyl chloride spray is an effective treatment for midazolam-induced hiccups in pediatric anesthesia.

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