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Use of intravenous midazolam for sedation in children undergoing ward procedures
1Dept of Paediatrics, Singapore General Hospital.
Insights
Midazolam effectively sedated 86% of pediatric patients for ward procedures, with a mean dose of 0.73mg/kg. While blood pressure dropped, no clinical effects or hypoventilation were observed, indicating good tolerance.
Area of Science:
- Pediatric Sedation
- Pharmacology
- Clinical Anesthesiology
Background:
- Midazolam, a water-soluble benzodiazepine, possesses anxiolytic and sedative properties.
- Its efficacy and tolerance for pediatric procedural sedation require further assessment.
Purpose of the Study:
- To evaluate the effectiveness and safety of midazolam for sedation in children undergoing various ward procedures.
- To determine optimal dosing and observe clinical effects.
Main Methods:
- A study involving 57 children (mean age 48 months, mean weight 15.7 kg) who received midazolam for sedation.
- Pethidine was administered for analgesia during bone marrow aspirations.
- Sedation efficacy, onset, duration, and adverse events were monitored.
Main Results:
- A midazolam dose of 0.73mg/kg adequately sedated 86% of children.
- Average onset of sedation was 4.3 minutes, with a mean duration of 88 minutes.
- Complete sedation was achieved in 47.5%, partial in 38.5%, and none in 14%; a significant but clinically insignificant drop in blood pressure occurred, with no detected hypoventilation.
Conclusions:
- Midazolam, at 0.73mg/kg, provides effective procedural sedation in children with a low incidence of adverse events.
- The drug demonstrates a favorable safety profile, with transient blood pressure changes and no hypoventilation observed.
- Further research could explore its use in diverse pediatric procedural settings.
Abstract:
Midazolam is a water-soluble benzodiazepine with low toxicity. It has anxiolytic and sedative effects. This study assessed the efficacy and tolerance of this drug for sedation in various ward procedures. Pethidine was added to bone marrow aspirations for analgesia. 57 children with the mean age of 48 months and mean weight of 15.7 kilograms were studied. The dose of midazolam used to sedate adequately 86% of the children was 0.73mg/kg, the average onset of sedation was 4.3 minutes and mean duration was about 88 minutes. 47.5% were completely sedated, whereas 38.5% were only partially sedated. In 14%, sedation was not achieved at all. There was a statistically significant drop in blood pressure after sedation but this was not associated with any clinical effects. Hypoventilation was not detected in this study.