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The Effect of Midazolam on Decreasing the Duration of Intussusception Hydrostatic Reduction in Children
Ali Eisapour1, Raheleh Mehrayin1, Mohammadreza Esmaeili-Dooki1
1Non-Communicable pediatric diseases research center, Babol University of medical science, Babol, Iran.
Insights
Midazolam, a sedative, may improve the success rate of non-surgical intussusception reduction in children. This study found a trend towards higher success with midazolam, though duration was similar between groups.
Area of Science:
- Pediatric Gastroenterology
- Radiology
- Pharmacology
Background:
- Intussusception is a common pediatric surgical emergency.
- Non-surgical reduction is the preferred treatment modality.
- Sedative medications may aid in successful reduction.
Purpose of the Study:
- To evaluate the efficacy of midazolam in reducing the duration of hydrostatic reduction for intussusception in children.
- To assess the impact of midazolam on the success rate of intussusception reduction.
Main Methods:
- A double-blind clinical trial involving 32 children with ileocolic intussusception.
- Randomized participants into two groups: midazolam and placebo.
- Administered intravenous midazolam (1.0 mg/kg) or placebo 5 minutes prior to fluoroscopy-guided barium reduction.
Main Results:
- 15 out of 16 patients (93.75%) in the midazolam group achieved successful reduction.
- 11 out of 16 patients (68.75%) in the placebo group achieved successful reduction (P=0.07).
- Mean reduction duration was similar between groups (34.8±11.35 min vs. 32.73±19.2 min).
Conclusions:
- Midazolam, a benzodiazepine with sedative and muscle relaxant properties, shows potential to increase the success rate of enema reduction for intussusception.
- Further research may be warranted to confirm the statistical significance of midazolam's effect on success rates.
Background And Objective:
The use of sedative medications may be effective in the success and facilitation of the intussusception non-surgical treatment. Therefore, the purpose of this study was to examine the effect of midazolam on decreasing the duration of intussusception hydrostatic reduction in children.
Materials And Methods:
In a double-blind clinical trial, 32 children were diagnosed with ileocolic intussusception based on sonographic findings, were studied and randomly divided into two groups. After obtaining written informed consent from the parents, 5 minutes before reduction, an intravenous Midazolam at the concentration of 1.0 mg/kg (up to 3 mg) was infused, and then barium reduction was performed under fluoroscopy guideline. In the control group, sterile water was injected as placebo and the remaining reduction steps were performed compared with the experiment group.
Results:
Of 16 patients that received Midazolam, 15 patients demonstrated successful reduction; and of 16 patients that received distilled water, only 11 patients showed successful reduction (P=0.07). The mean duration of a successful reduction in the Midazolam group and placebo was 34.8±11.35 and 32.73±19.2 min, respectively (P=0.733).
Conclusions:
The use of Midazolam as a benzodiazepine with known sedative and muscle relaxant effects can increase the success rate of enema reduction in intussusception.
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