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midazolam children

Eva Germovsek, Charlotte Barker, Mike Sharland, Joseph F Standing
AIM(S): When different models for weight and age are used in paediatric pharmacokinetic studies it is difficult to compare parameters between studies or perform model-based meta-analysis. This study aimed to compare published models with the proposed standard (allometric weight(0.75) and sigmoidal maturation function). METHODS: A systematic literature search was undertaken to identify published clearance (CL) reports for gentamicin and midazolam and all published models for scaling clearance in children...
October 21, 2016: British Journal of Clinical Pharmacology
Madhuri S Kurdi, Sindhu Priya Muthukalai
BACKGROUND AND AIMS: Melatonin (MT), a naturally occurring pituitary hormone has a sleep promoting effect. There are very few studies on pre-operative oral MT (0.2-0.5 mg/kg) in children. We planned a study to assess the efficacy of oral MT in two doses and compare it with oral midazolam and placebo for pre-operative anxiolysis, sedation, maintenance of cognition and psychomotor skills, parental separation behaviour and venepuncture compliance. METHODS: This prospective double-blind randomised study was conducted after ethical committee approval on 100 children aged 5-15 years, American Society of Anaesthesiologists physical status I and II undergoing elective surgery at our hospital from January 1, 2014, to December 31, 2014...
October 2016: Indian Journal of Anaesthesia
L X Quan, H X An, D X Wang
OBJECTIVE: To observe the effects of 0.4 μg/(kg×h) dose of dexmedetomidine on intra-operative wake-up test in children patients undergoing scoliosis surgery. METHODS: Sixty patients for posterior scoliosis correction (ASA I-II, aged 5-16 years) from March 2013 to April 2015 were enrolled in this prospective, double-blinded, randomized, placebo-controlled study, The patients were randomly classified into two groups to receive dexmedetomidine (group RD, n=30) or saline solution (group R, n=30)...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
David Smith, High Cheek, Brenda Denson, Christopher M Pruitt
OBJECTIVE: Intranasal (IN) midazolam is a commonly prescribed medication for pediatric sedation and anxiolysis. One of its most frequently-encountered adverse effects is discomfort with administration. While it has been proposed that premedicating with lidocaine reduces this undesirable consequence, this combination has not been thoroughly researched. The objective of our study was to assess whether topical lidocaine lessens the discomfort associated with IN midazolam administration. METHODS: This was a double-blinded, randomized, placebo-controlled trial performed in an urban, academic pediatric emergency department...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Babita Ghai, Kajal Jain, Akshay Kumar Saxena, Nidhi Bhatia, Kushaljit Singh Sodhi
BACKGROUND: Children undergoing computerized tomography (CT) frequently require sedation to allay their anxiety, and prevent motion artifacts and stress of intravenous (IV) cannulation. AIMS: The aim of this trial was to compare the effectiveness of oral midazolam and intranasal dexmedetomidine as sole premedicants in children for carrying out both IV cannulation as well as CT scanning, without the need for additional IV sedatives. METHODS: Fifty-nine children, aged 1-6 years, scheduled to undergo CT imaging under sedation were randomized to receive either 0...
October 13, 2016: Paediatric Anaesthesia
Pilar Anton-Martin, Vinai Modem, Donna Taylor, Donald Potter, Cindy Darnell-Bowens
INTRODUCTION: The purpose of this study is to describe the sedative and analgesic requirements identifying factors associated with medication escalation in neonates and children supported on ECMO. METHOD: Observational retrospective cohort study in a tertiary pediatric intensive care unit from June 2009 to June 2013. RESULTS: One hundred and sixty patients were included in the study. Fentanyl and midazolam were the first line agents used while on ECMO...
October 10, 2016: Perfusion
Ulas E Akbulut, Sedat Saylan, Bilal Sengu, Gulgun E Akcali, Engin Erturk, Murat Cakir
PURPOSE: We aimed to compare the efficacy and safety of midazolam plus ketamine versus fentanyl plus propofol combination administered to children undergoing upper gastrointestinal endoscopy (UGE) and to determine the most appropriate sedation protocol. MATERIALS AND METHODS: This prospective, randomized, single-blind study included patients between the ages of 4 and 17 years who underwent UGE for diagnostic purposes. Patients were divided randomly into groups A (midazolam-ketamine combination, n=119) and B (fentanyl plus propofol combination, n=119)...
September 26, 2016: European Journal of Gastroenterology & Hepatology
Sengül Özmert, Feyza Sever, Hüseyin Tuğrul Tiryaki
PURPOSE: In this study, we retrospectively investigated case reports with and without midazolam administration via oral, intranasal and rectal before cystometry procedure. We aimed to compare the data to evaluate the effects of sedation before cystometry on the pediatric patients and parents' satisfaction. METHODS: A total of 124 ASA I-II pediatric cases aged 5-14 years were retrospectively investigated from the hospital records. One of the three administration routes was chosen; oral midazolam at a dose of 0...
2016: SpringerPlus
Alberto Dionigi, Paola Gremigni
AIMS: To test whether a combined intervention of art therapy and clown visits could enhance the efficacy of oral medication in reducing children's anxiety at parental separation prior to induction of anesthesia. BACKGROUND: Approximately 50% of children undergoing surgery report high anxiety at anesthesia induction. Complementary therapies have been used to decrease children's anxiety, but no study has evaluated the efficacy of a combination of such therapies. DESIGN: This is an observational study, which involved allocating different interventions to two groups and measuring their anxiety at two time points...
September 14, 2016: Journal of Clinical Nursing
Purvashree Vijay Deshmukh, Sadhana Sudhir Kulkarni, Mukund Kachru Parchandekar, Sneha Purshottam Sikchi
BACKGROUND AND AIMS: Preoperative anxiety in children leading to postoperative negative changes and long-term behavioral problems needs better preanesthetic sedation. Across the world, midazolam is the most commonly used premedicant in pediatric patients. The fact that no single route has achieved universal acceptance for its administration suggests that each route has its own merits and demerits. This study compares oral midazolam syrup and intranasal midazolam spray as painless and needleless systems of drug administration for preanesthetic sedation in children...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Daniel Crawford
Currently, evidence supports the use of intranasal midazolam as an effective, and in many cases, preferable treatment option for prolonged seizures in children. Despite this knowledge, intranasal midazolam is not routinely found as a standard of care. The goal of this project was to implement the use of intranasal midazolam as a rescue medication for prolonged seizures within a child neurology practice and, in doing so, create a model for implementation that would be replicable for other practice sites. This project focused on the development of a process to make intranasal midazolam available as a treatment option and then the creation of an educational intervention for providers within a child neurology practice...
September 5, 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Fathima Peerbhay, Ahmed Mahgoub Elsheikhomer
The purpose of this study was to compare the effectiveness and recovery times of 0.3 and 0.5 mg/kg intranasal midazolam (INM) administered with a mucosal atomizer device (MAD) in a pediatric emergency dental hospital clinic. One hundred eighteen children aged from 4 to 6 years were randomly administered either 0.3 or 0.5 mg/kg INM via an MAD in a triple-blinded randomized controlled trial. Sedation was achieved to some degree in 100% of the sample. The pulse rate and oxygen saturation were within the normal range in 99% of the patients...
2016: Anesthesia Progress
Najia Mansoor, Tasneem Ahmad, Rafeeq Alam Khan, Syed Mohammad Sharib, Iftekhar Mahmod
Children are not small adults because besides size there are subtle physiological and biochemical differences between children and adults. Like adults, children also require medicine for the management or cure for the underlying diseases. To select a right dose in children, pharmacokinetic (PK) information is warranted. However, in many instances, a PK study in neonates and infants may not be possible. Therefore, various methods are used to predict PK parameters in this group of population, and these predicted parameters may help to calculate a safe dose for the very young children...
August 29, 2016: American Journal of Therapeutics
Maha A AlSarheed
OBJECTIVES: To identify the intranasal (IN) sedatives used to achieve conscious sedation during dental procedures amongst children. METHODS: A literature review was conducted by identifying relevant studies through searches on Medline. Search included IN of midazolam, ketamine, sufentanil, dexmedetomidine, clonidine, haloperidol, and loranzepam. Studies included were conducted amongst individuals below 18 years, published in English, and were not restricted by year...
September 2016: Saudi Medical Journal
Robert C Tasker, Howard P Goodkin, Iván Sánchez Fernández, Kevin E Chapman, Nicholas S Abend, Ravindra Arya, James N Brenton, Jessica L Carpenter, William D Gaillard, Tracy A Glauser, Joshua Goldstein, Ashley R Helseth, Michele C Jackson, Kush Kapur, Mohamad A Mikati, Katrina Peariso, Mark S Wainwright, Angus A Wilfong, Korwyn Williams, Tobias Loddenkemper
OBJECTIVE: To describe pediatric patients with convulsive refractory status epilepticus in whom there is intention to use an IV anesthetic for seizure control. DESIGN: Two-year prospective observational study evaluating patients (age range, 1 mo to 21 yr) with refractory status epilepticus not responding to two antiepileptic drug classes and treated with continuous infusion of anesthetic agent. SETTING: Nine pediatric hospitals in the United States...
October 2016: Pediatric Critical Care Medicine
Michal Zelcer, Ran D Goldman
QUESTION: There are times when parents arrive to my clinic after their child has had a seizure and a second seizure takes place in the clinic. While waiting for transport to the hospital, are there ways to stop the seizures without the need to obtain intravenous access in the clinic? ANSWER: Intravenous diazepam has been a first-line therapy to stop seizures in children for many years. Other routes of drug administration such as intramuscular, rectal, and buccal are available but have several limitations...
July 2016: Canadian Family Physician Médecin de Famille Canadien
S Prakash, V K Pai, M Dhar, A A Kumar
Children with autistic spectrum disorders are often encountered in anesthesia practice mainly for outdoor procedural sedation or anesthesia in endoscopy and magnetic resonance imaging suites. We describe a case of a 7-year-old autistic boy who required management of dental caries. He had a phobia to intravenous cannulation, displayed increasing anxiety and became combative on the day of surgery. With parental involvement and distraction, we succeeded in giving oral midazolam by concealing it, with the intent of avoiding intramuscular injection or unnecessary restraint...
July 2016: Saudi Journal of Anaesthesia
R Wang, W H Wang
OBJECTIVE: To evaluate the effects of intranasal midazolam premedication on children who undergoing inhaled induction of anesthesia with sevoflurane. METHODS: One hundred American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ children undergoing elective operations in Tianjin Medical University Cancer Institute and Hospital from June 2014 to June 2015 were randomly assigned into 2 groups, and 50 cases in each group. Patients received different intranasal premedication giving 30 min before anesthesia: midazolam 0...
June 28, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Orit Rubinstein, Shiri Barkan, Rachelle Breitbart, Sofia Berkovitch, Michal Toledano, Giora Weiser, Natali Karadi, Anat Nassi, Eran Kozer
OBJECTIVE: To assess the efficacy of oral ketamine versus oral midazolam for sedation during laceration repair at a pediatric emergency department. METHODS: Children between 1 and 10 years requiring laceration repair were randomly assigned to 2 groups, treated either with oral midazolam (0.7 mg/kg) or with oral ketamine (5 mg/kg).Main outcomes measured were level of pain during local anesthesia, as assessed by the parent on a 10-cm visual analog scale (VAS) and the number of children who required intravenous sedation...
June 2016: Medicine (Baltimore)
Aysun Ankay Yılbaş, Banu Ayhan, Seda Banu Akıncı, Fatma Sarıcaoğlu, Ülkü Aypar
OBJECTIVE: In this study, we aimed to compare the effects of different intraoperative end-tidal desflurane concentrations on bispectral index (BIS) values in normal children and children with cerebral palsy. METHODS: Twenty normal children (Group N) and 20 children with non-communicative/nonverbal cerebral palsy (Group CP), between 2 and 15 years of age, undergoing elective orthopaedic surgery were included in the study. Following premedication with midazolam, anaesthesia was induced by infusing 1% propofol at a rate of 200 mL hr(-1) until BIS reached 50...
December 2013: Turkish Journal of Anaesthesiology and Reanimation
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