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Oral versus intravenous premedication for small bowel biopsy in children: effect on procedure and fluoroscopy times
L Stenhammar1, O Wärngård, P Lewander
1Department of Paediatrics, Central Hospital, Norrköping, Sweden.
Insights
Intravenous (IV) midazolam and metoclopramide significantly reduced small bowel biopsy procedure times in children compared to oral premedication. This IV approach offers more effective sedation for pediatric patients undergoing this diagnostic procedure.
Area of Science:
- Pediatric Gastroenterology
- Anesthesiology
- Medical Imaging
Background:
- Pediatric small bowel biopsy is an important diagnostic tool.
- Effective sedation is crucial for successful pediatric procedures.
- Optimizing procedural efficiency and patient comfort is a clinical priority.
Purpose of the Study:
- To compare the efficacy of different premedication regimens for pediatric small bowel biopsy.
- To evaluate the impact of oral versus intravenous (IV) premedication on procedure and fluoroscopy times.
- To determine the optimal sedation strategy for children undergoing small bowel biopsy.
Main Methods:
- A study involving 185 children undergoing small bowel biopsy.
- Three groups received different premedication: oral alimemazine/cisapride, oral diazepam/cisapride, or IV midazolam/metoclopramide.
- Procedure and fluoroscopy times were recorded under intermittent fluoroscopy.
Main Results:
- The median biopsy procedure time was significantly shorter with IV midazolam/metoclopramide (6 min) versus oral premedication (10 min) (p < 0.001).
- Median fluoroscopy times were minimal across all groups (3-6 seconds).
- IV premedication provided more effective sedation.
Conclusions:
- Intravenous premedication, specifically midazolam and metoclopramide, is superior to oral premedication for pediatric small bowel biopsy.
- This IV regimen leads to shorter procedure times and improved sedation efficacy.
- Optimized sedation enhances the success and efficiency of pediatric endoscopic procedures.
Abstract:
Oral alimemazine and cisapride, or diazepam and cisapride, or iv midazolam and metoclopramide were given as premedication for small bowel biopsy to three groups of children from a total population of 185 individuals. The biopsy procedures were performed under intermittent fluoroscopy and times for both were recorded. The median biopsy procedure time was significantly shorter in children given iv midazolam and metoclopramide (6 min) compared to those given oral premedication (10 min) (p < 0.001). The median fluoroscopy time was very short in all groups, ranging between 3 and 6 s. It is concluded that iv premedication is superior to oral premedication for small bowel biopsy in children because more effective sedation is obtained.