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Comparison of Oral Midazolam With Intravenous Midazolam for Sedation Children During Upper Gastrointestinal Endoscopy

Ahmad Khodadad1, Majid Aflatoonian2, Rozita Jalilian1

  • 1Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Acta Medica Iranica
|November 12, 2016
PubMed

Insights

Oral midazolam offers a safe and effective sedation option for pediatric upper endoscopy, significantly improving patient comfort and reducing anxiety during separation from parents compared to intravenous midazolam.

Area of Science:

  • Pediatric Gastroenterology
  • Anesthesiology
  • Pharmacology

Background:

  • Upper endoscopy is a common diagnostic and therapeutic procedure for upper digestive tract diseases.
  • Sedation safety and efficacy are critical concerns in pediatric gastrointestinal procedures.
  • Midazolam is frequently used for procedural sedation in children.

Purpose of the Study:

  • To compare the efficacy and safety of oral midazolam versus intravenous (IV) midazolam for sedation in children undergoing upper endoscopy.
  • To evaluate differences in sedation onset, patient-parent separation, and patient comfort between the two administration routes.

Main Methods:

  • A randomized blinded interventional study involving 119 children undergoing upper endoscopy.
  • Participants were randomized to receive either oral midazolam or IV midazolam for sedation.
  • Outcomes assessed included time to sedation, ease of separation from parents, and patient comfort during the procedure.

Main Results:

  • Intravenous midazolam achieved faster sedation onset (2.2 minutes) compared to oral midazolam (30.9 minutes).
  • Oral midazolam resulted in significantly easier separation from parents (93% without resistance) versus IV midazolam (38.3% without resistance).
  • Patient comfort and parental consent were significantly higher in the oral midazolam group.

Conclusions:

  • Oral midazolam is a safe and effective alternative for sedation during pediatric upper endoscopy.
  • Oral midazolam enhances patient comfort and reduces anxiety, facilitating the procedure compared to IV administration.
  • Neither route consistently achieved deep sedation levels in most pediatric patients.

Keywords:
Gastrointestinal endoscopyIntravenousMidazolamSedation

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