Related Experiment Video

Updated: Jun 24, 2026

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
09:47

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery

Published on: June 2, 2022

Minimal sedation second dose strategy with intranasal midazolam in an outpatient pediatric echocardiographic setting

Judith P Lazol1, Curt G DeGroff

  • 1Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|April 7, 2009
PubMed

Insights

A second dose of intranasal midazolam (INM) effectively sedated uncooperative children during echocardiography, improving study quality. This strategy minimized risks and discharge delays, proving beneficial for pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Pediatric Sedation
  • Medical Imaging

Background:

  • Child anxiety and movement during transthoracic echocardiography (TTE) can compromise diagnostic quality.
  • Minimal sedation is often necessary for successful pediatric TTE procedures.
  • Intranasal midazolam (INM) is a viable sedative option, but optimal dosing strategies for TTE remain unclear.

Purpose of the Study:

  • To evaluate the effectiveness of a second-dose INM sedation strategy for children undergoing TTE.
  • To assess the safety and efficacy of a specific INM dosing protocol.

Main Methods:

  • Retrospective review of 100 pediatric patients (1-59 months) undergoing TTE.
  • Administration of a second INM dose if needed 10-15 minutes after the initial dose to achieve anxiolysis.
  • Assessment of sedation levels and procedural success.

Main Results:

  • Eighty percent of patients achieved satisfactory minimal sedation levels.
  • No serious complications were reported.
  • Minimal side effects and no delays in patient discharge were observed.

Conclusions:

  • A second-dose INM strategy is effective for achieving adequate sedation in children undergoing TTE.
  • This approach enhances the reliability of echocardiographic studies in pediatric populations.
  • A single INM dose may be insufficient for a significant proportion of children requiring sedation for TTE.
Abstract

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Drug Delivery: Enteral Route01:18

Drug Delivery: Enteral Route

The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
Drugs in...
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...