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Midazolam Pediatrics

James H Hertzog, Krista Preisberga, Scott Penfil
BACKGROUND AND OBJECTIVES: Anaphylaxis is rare but life-threatening. Its incidence during pediatric procedural sedation outside of the operating room is unknown. We used data from the Pediatric Sedation Research Consortium (PSRC) to determine the incidence and nature of allergic and anaphylactic reactions in this practice. METHODS: A retrospective observational study of prospectively collected information in the PSRC's multicenter database was performed. Cases of allergic reaction were identified...
December 12, 2018: Hospital Pediatrics
Sedigheh Mozafar, Majid Bargrizan, Mojtaba Vahid Golpayegani, Shahnaz Shayeghi, Rahil Ahmadi
Background: This study compared the safety and efficacy of nitrous oxide (N2 O)/midazolam and N2 O/promethazine for dental treatment of uncooperative children. Materials and Methods: In this randomized, cross-over, clinical trial investigation Eighteen healthy uncooperative children with a pair of similar teeth requiring the same treatment were included. Combination of N2 O/midazolam was given in one visit, where N2 O/promethazine was administrated in the other appointment for each patient in a cross-over manner...
November 2018: Dental Research Journal
Palita Arayakarnkul, Krisnachai Chomtho
BACKGROUND: Super-refractory status epilepticus (SRSE) is a seizure that continues >24 h after anesthesia, or recurs on the reduction of anesthesia. SRSE is extremely difficult-to-control and associated with poor outcome. To date, optimal therapy and outcome data in children is limited. OBJECTIVE: To assess etiology, treatment options and outcome in pediatric SRSE patients. METHOD: We reviewed medical records of children <15 years old with SRSE during 2007-2017 at King Chulalongkorn Memorial Hospital...
December 7, 2018: Brain & Development
Asma Djabri, Richard H Guy, M Begoña Delgado-Charro
Drug delivery to the neonatal and premature pediatric populations is very challenging. This research assessed the potential of delivering midazolam by transdermal iontophoresis as an alternative strategy in pediatric therapy. In vitro experiments used intact and tape-stripped porcine skin as models for the skin barrier function of full-term and premature newborns, respectively. Midazolam transdermal transport was significantly enhanced by applying higher currents, increasing the formulation pH, and optimizing the drug's mole fraction in the vehicle...
November 29, 2018: European Journal of Pharmaceutical Sciences
Shin-Ichiro Hamano, Kenji Sugai, Masuo Miki, Toshiyuki Tabata, Takako Fukuyama, Makiko Osawa
BACKGROUND: No dosing regimen has been established for the initial treatment of pediatric status epilepticus with intravenous midazolam. We therefore evaluated the efficacy, safety, and pharmacokinetics of bolus and continuous midazolam infusion. METHODS: This open-label, prospective, multicenter study involved 34 Japanese children with status epilepticus unresponsive to diazepam. An initial bolus of 0.15 mg/kg midazolam was given, with additional doses of 0.1-0...
October 4, 2018: Journal of the Neurological Sciences
Selma Çakmakcı, Turan Bayhan, Meriç Kaymak Cihan, İnci Ergürhan İlhan
No abstract text is available yet for this article.
September 2018: Türk Pediatri Arşivi
Sylvia Kramer, Martin Krebs, Claudia Spies, Shahab Ghamari, Claudia Höhne, Karin Becke, Christoph Eich, Andreas Hoeft, Julius Wermelt, Richard K Ellerkmann
The upcoming and ongoing debate on neurotoxicity of anesthetics at a young age put a new spotlight on the emergence delirium of children (paedED). The European Society for Anesthesiology published a consensus guideline on prevention and therapy in 2017 which can be a useful guidance in daily clinical practice. Patient data management systems with their clear documentation concerning pain/therapy of pain and paedED will be valuable tools in order to assess the real incidence of paedED. Differentiating between pain/agitation and paedED migth not always be easy...
November 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Majid Mehran, Ghassem Ansari, Mojtaba Vahid Golpayegani, Shahnaz Shayeghi, Leila Shafiei
Background. The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine combinations on fearful children needing dental treatment. Methods. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received...
2018: Journal of Dental Research, Dental Clinics, Dental Prospects
Itai Shavit, Danielle Shavit, Oren Feldman, Nir Samuel, Anat Ilivitzki, Daniel M Cohen
BACKGROUND: Ileocolic intussusception is a major cause for intestinal obstruction in early childhood. Reduction of intussusception, in the vast majority of institutions, is performed on awake children, without sedation. OBJECTIVE: The aim of this study was to report the course of the first patients who were sedated by emergency physicians for pneumatic reduction of intussusception (PRI). METHODS: We conducted a case series analysis of prospectively collected data on patients undergoing PRI, using a sedation recording tool...
October 30, 2018: Journal of Emergency Medicine
Natalie C Luehmann, Michelle E Staubach, Begum Akay, Phillip J Collier, Richard E Han, Thomas W Riggs, Nathan M Novotny
BACKGROUND/PURPOSE: We initiated a pediatric surgical program including a caregiver for the induction of anesthesia. We measured preoperative midazolam administration, preoperative time, induction time, and program satisfaction. METHODS: Families with children undergoing surgery during the study period were included. Preoperative midazolam administration, preoperative time, and induction time were compared between participants and controls. Satisfaction surveys were given to participating caregivers and staff...
October 5, 2018: Journal of Pediatric Surgery
Becky Olacke, Travis Nelson, Elise Sarvas, JoAnna M Scott
Purpose: The purpose of this study was to assess the use of a dosing scalar for association with the success of procedural sedation in pediatric dentistry. Methods: This cross-sectional, retrospective study assessed healthy two- to 12-year-olds who received an elixir of midazolam (0.3 mg/kg), meperidine (1.5 mg/kg), and hydroxyzine (1.0 mg/kg). The scaled body weight (SBW) for each patient was determined using the 50th percentile weight-for-age from the 2000 Centers for Disease Control and Prevention (CDC) growth chart...
September 15, 2018: Pediatric Dentistry
Amgad H Hanna, Davinder Ramsingh, Whitney Sullivan-Lewis, Sarah Cano, Patrick Leiter, Desiree Wallace, Gerald Andrews, Briahnna Austin, Richard L Applegate
BACKGROUND: Anxiety associated with pediatric surgery can be stressful. Midazolam is a well-accepted anxiolytic in this setting. However, there are cases in which this medication is not effective. Zolpidem is a short-acting nonbenzodiazepine hypnotic drug that is administered orally and has quick onset of action (~15 minutes), and 2-3 hour duration. AIMS: Based on the theory that impaired perception following oral zolpidem administration would suppress the development of anxiety, we sought to compare zolpidem to midazolam for pediatric preoperative anxiety...
October 17, 2018: Paediatric Anaesthesia
Astha Jaikaria, Seema Thakur, Parul Singhal, Deepak Chauhan, Cheranjeevi Jayam, Kartik Syal
Introduction: It is common to encounter a patient who is anxious to the magnitude that precludes the possibility of provision of dental treatment. This study aims to evaluate and compare the sedative effect of oral combinations of midazolam-ketamine (MK), dexmedetomidine-fentanyl (DF), and dexmedetomidine-ketamine (DK) in a group of uncooperative children requiring dental treatment. Methodology: This was a prospective, randomized, triple-blind study where 36 children who were 3-9 year old with American Society of Anesthesiologists -I status and presenting early childhood caries were randomly assigned to: Group A - 0...
September 2018: Contemporary Clinical Dentistry
Kate Madden, Kinza Hussain, Robert C Tasker
OBJECTIVES: It is important to describe and understand the prevalence and risk factors for the syndrome of delirium in critical illness. Since anticholinergic medication may contribute to the development of delirium in the PICU, we have sought to quantify anticholinergic medication exposure in patients with prolonged admission. We have used Anticholinergic Drug Scale scores to quantify the magnitude or extent of this burden. DESIGN: Retrospective cohort study, January 2011 to December 2015...
October 2018: Pediatric Critical Care Medicine
Veena Chatrath, Rajan Kumar, Upasna Sachdeva, Milind Thakur
Background: Surgery is a very stressful experience for patients. Children are the most susceptible to fear, anxiety, and stress due to their limited cognitive capabilities and dependency. In children, pharmacologic agents are frequently used as premedication to relieve the fear of surgery, to make child-parental separation easy, and to carry out a smooth induction of anesthesia. We conducted this study to compare the efficacy of intranasal fentanyl, midazolam, and dexmedetomidine as premedication in pediatric patients...
July 2018: Anesthesia, Essays and Researches
Bi L Li, Vivian M Yuen, Jia L Zhou, Na Zhang, Jun X Huang, Hang Tian, Xing R Song
BACKGROUND: Moderate to deep sedation is required for an auditory brainstem response test when high-intensity stimulation is used. Chloral hydrate is the most commonly used sedative, whereas intranasal dexmedetomidine is increasingly used in pediatric non-painful procedural sedations. OBJECTIVE: The aim of this study was to compare the sedation success rate after oral chloral hydrate at 50 mg kg-1 and intranasal dexmedetomidine at 3 μg kg-1 plus buccal midazolam at 0...
November 2018: Paediatric Anaesthesia
Greta Vladinov, Lilibeth Fermin, Renee Longini, Yanett Ramos, Edward Maratea
This study provides a review of the contemporary literature for the effects of most commonly used anesthetic drugs for sedation and anesthesia during adult electrophysiologic (EP) studies where supraventricular tachycardias (SVT) need to be induced for diagnostic purposes and/or catheter ablation. Some medications may affect cardiac electrophysiology and conduction, altering the ability to induce the arrhythmia, and may have negative impact on mapping and ablation treatment. The objective of the study is to determine the best sedative choice during SVT ablations...
November 2018: Pacing and Clinical Electrophysiology: PACE
Thomas J Caruso, Jeremy H Tsui, Ellen Wang, David Scheinker, Paul J Sharek, Christine Cunningham, Samuel T Rodriguez
Introduction: Most children undergoing anesthesia experience significant preoperative anxiety. We developed a bedside entertainment and relaxation theater (BERT) as an alternative to midazolam for appropriate patients undergoing anesthesia. The primary aim of this study was to determine if BERT was as effective as midazolam in producing cooperative patients at anesthesia induction. Secondary aims reviewed patient emotion and timeliness of BERT utilization. Methods: We conducted a retrospective cohort study of pediatric patients undergoing anesthesia at Lucile Packard Children's Hospital Stanford between February 1, 2016, and October 1, 2016...
July 2018: Pediatric quality & safety
Patrick M Ryan, Andrew J Kienstra, Peter Cosgrove, Robert Vezzetti, Matthew Wilkinson
OBJECTIVE: To examine the safety and effectiveness of intranasal midazolam and fentanyl used in combination for laceration repair in the pediatric emergency department. METHODS: We performed a retrospective chart review of a random sample of 546 children less than 18 years of age who received both intranasal midazolam and fentanyl for laceration repair in the pediatric emergency department at a large, urban children's hospital. Records were reviewed from April 1, 2012 to June 31, 2015...
May 17, 2018: American Journal of Emergency Medicine
Masahiro Nishiyama, Hiroaki Nagase, Kazumi Tomioka, Tsukasa Tanaka, Hiroshi Yamaguchi, Yusuke Ishida, Daisaku Toyoshima, Kyoko Fujita, Azusa Maruyama, Hiroshi Kurosawa, Yoshiyuki Uetani, Kandai Nozu, Mariko Taniguchi-Ikeda, Ichiro Morioka, Satoshi Takada, Kazumoto Iijima
BACKGROUND: Fosphenytoin (fPHT) and continuous intravenous midazolam (cMDL) had commonly been used as second-line treatments for pediatric status epilepticus (SE) in Japan. However, there is no comparative study of these two treatments. METHODS: We included consecutive children who 1) were admitted to Kobe Children's Hospital because of convulsion with fever and 2) were treated with either fPHT or cMDL as second-line treatment for convulsive SE lasting for longer than 30 min...
November 2018: Brain & Development
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