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A retrospective study on the effectiveness of intranasal midazolam in pediatric burn patients
S L Hansen1, D W Voigt, C N Paul
1Saint Elizabeth Regional Burn & Wound Care Center, Lincoln, Nebraska 68510, USA.
Insights
Intranasal midazolam (INM) combined with other pain medications effectively managed pain and anxiety in pediatric burn patients during wound care. Nursing staff documented positive patient responses to this combined treatment approach.
Area of Science:
- Pediatric Burn Care
- Pain Management
- Anesthesiology
Background:
- Pain control is a significant challenge in pediatric burn patients, particularly during wound cleansing and dressing changes.
- Anxiety and pain during these procedures are difficult to manage, especially without intravenous access.
Purpose of the Study:
- To explore the effectiveness of intranasal midazolam (INM) in conjunction with other pain medications for managing pain and anxiety in pediatric burn patients.
- To assess patient response to INM prior to painful procedures.
Main Methods:
- A retrospective chart review of pediatric patients under 9 years old admitted between October 1995 and November 1996.
- Twelve patients who received INM were included, with each child serving as their own control.
- Pain and response to medication during wound cleansing were assessed via nursing staff documentation.
Main Results:
- Nursing documentation indicated positive patient responses when intranasal midazolam was used alongside intravenous and/or oral pain medications.
- The combined approach demonstrated effectiveness in managing procedural pain and anxiety.
Conclusions:
- Intranasal midazolam, when combined with standard pain medications, appears to be an effective strategy for pain and anxiety control in pediatric burn patients undergoing wound care.
- This method offers a viable alternative for pain management, particularly when intravenous access is limited.
Abstract:
Pain control is a major issue concerning children admitted for burns. Pain and anxiety associated with twice daily wound cleansing and dressing changes are difficult to control, especially if there is no intravenous access. We explored the effectiveness of intranasal midazolam (INM) combined with intravenous and/or oral pain medications prior to painful treatments. Charts of all patients admitted from October 1995 to November 1996 under the age of 9 were reviewed for use of INM. Twelve patients had INM used at some point during their hospitalization. Our study covers this group, with each child acting as his/her own control. Pain and response to medication during wound cleansing was assessed by the nursing staff as documented in the patient's nursing assessment. Nursing documentation indicated that patient response was positive regarding the use of INM with intravenous and/or oral pain medication.