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Oral midazolam for voiding dysfunction in children undergoing voiding cystourethrography: a controlled randomized
Anoush Azarfar1, Mohammad Esmaeeili1, Azadeh Farrokh1
1Department of Pediatric, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Insights
Oral midazolam significantly reduced stress and improved cooperation in children undergoing Voiding Cystourethrography (VCUG). This sedative approach is beneficial for pediatric urinary tract infection evaluations.
Area of Science:
- Pediatric Urology
- Clinical Pharmacology
Background:
- Voiding Cystourethrography (VCUG) is the gold standard for diagnosing vesicoureteral reflux.
- VCUG is essential in the workup for pediatric urinary tract infections and voiding dysfunction.
Purpose of the Study:
- To compare the efficacy of oral midazolam versus no sedation for children undergoing VCUG.
- To assess the impact of midazolam on patient comfort and cooperation during the procedure.
Main Methods:
- A randomized clinical trial involving 84 children undergoing VCUG.
- The intervention group received 0.5 mg/kg of oral midazolam 30 minutes prior to the procedure.
- Statistical methods were used to compare outcomes between the midazolam and control groups.
Main Results:
- Urinary tract infections were the primary indication for VCUG in over half of the participants.
- Post-procedure dysuria was more common in girls.
- Children receiving midazolam exhibited significantly less urinary irritation and restlessness one week after the procedure.
Conclusions:
- Oral midazolam at 0.5 mg/kg effectively reduces pediatric patient stress during VCUG.
- Midazolam administration enhances cooperation, improving the overall procedural experience for children.
Background:
Voiding Cystourethrography (VCUG) is the gold standard of detecting and grading the vesicoureteral reflux. Moreover, VCUG is a part of the standard review for infants and children with a urinary tract infection and urinary dysfunction.
Objectives:
The purpose of our study was to compare using oral midazolam in contrast to prescribing no sedative medication for voiding dysfunction in children undergoing VCUG.
Patients And Methods:
In a clinical trial, we studied 84 children referred for VCUG. Children were allocated randomly into two equal groups. The intervention group received 0.5 mg/kg midazolam orally half an hour before the VCUG procedure. Then both groups were compared using statistical methods.
Results:
Then both groups were compared using statistical methods. In more than half of the patients, the main cause of performing VCUG was urinary tract infection. Dysuria was evaluated immediately after VCUG and was more frequent in girls than in boys (P = 0.006). After one week, the urinary irritation and restlessness in the intervention group was significantly lower than the control group.
Conclusion:
The use of midazolam 0.5 mg/kg reduced children's stress and increased their cooperation during the procedure.
