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Midazolam Pediatrics

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...
October 3, 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...
September 24, 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
Seyed Mohsen Dehghani, Mahmood Haghighat, Farideh Nematollahi, Hazhir Javaherizadeh, Naser Honar, Maryam Bahmanyar, Maryam Ataollahi
INTRODUCTION: The aim of this study was to evaluate complications after percutaneous endoscopic gastrostomy among children who underwent percutaneous endoscopic gastrostomy in Nemazee hospital. MATERIALS AND METHODS: All children who underwent percutaneous endoscopic gastrostomy were included in the current study. Place of the study was department of pediatric gastroenterology of Nemazee children hospital of Shiraz university of medical sciences. Duration of the study was 5 year starting from 2008...
April 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Viviane G Nasr, James A DiNardo
No abstract text is available yet for this article.
August 2018: Pediatric Critical Care Medicine
Sigalit Blumer, Rabea Iraqi, Roly Bercovich, Benjamin Peretz
OBJECTIVE: We aimed to examine if changes in oxygen saturation and pulse rate of pediatric patients during conscious sedation with midazolam and nitrous oxide are associated with child's behavior, midazolam dose, the type and duration of the treatment and demographic parameters. STUDY DESIGN: This study was a retrospective chart review of consecutive pediatric patients, aged 2.5-12.5 years, who had undergone conscious sedation for dental treatment with oral midazolam (with or without nitrous oxide) between January 2011 and September 2015 at the Department of Pediatric Dentistry of Tel Aviv University...
August 7, 2018: Journal of Clinical Pediatric Dentistry
Susan E Warrington, Hailey K Collier, Adam S Himebauch, Heather A Wolfe
OBJECTIVES: To evaluate if institutionally established calculations for transitioning continuous IV midazolam to enteral benzodiazepines maintain Withdrawal Assessment Tool-Version 1 scores equal to or less than preconversion values. DESIGN: Retrospective cohort study evaluating the effectiveness and safety of benzodiazepine conversion calculations embedded within an institution-specific clinical pathway for sedation and weaning of mechanically ventilated pediatric patients...
August 3, 2018: Pediatric Critical Care Medicine
Alejandra Vasquez, Marina Gaínza-Lein, Iván Sánchez Fernández, Nicholas S Abend, Anne Anderson, J Nicholas Brenton, Jessica L Carpenter, Kevin Chapman, Justice Clark, William D Gaillard, Tracy Glauser, Joshua Goldstein, Howard P Goodkin, Yi-Chen Lai, Tobias Loddenkemper, Tiffani L McDonough, Mohamad A Mikati, Anuranjita Nayak, Eric Payne, James Riviello, Dmitry Tchapyjnikov, Alexis A Topjian, Mark S Wainwright, Robert C Tasker
OBJECTIVE: We aimed to evaluate and compare the status epilepticus treatment pathways used by pediatric status epilepticus research group (pSERG) hospitals in the United States and the American Epilepsy Society (AES) status epilepticus guideline. METHODS: We undertook a descriptive analysis of recommended timing, dosing, and medication choices in 10 pSERG hospitals' status epilepticus treatment pathways. RESULTS: One pathway matched the timeline in the AES guideline; nine pathways described more rapid timings...
July 11, 2018: Pediatric Neurology
Janneke M Brussee, Huixin Yu, Elke H J Krekels, Semra Palić, Margreke J E Brill, Jeffrey S Barrett, Amin Rostami-Hodjegan, Saskia N de Wildt, Catherijne A J Knibbe
PURPOSE: Changes in drug absorption and first-pass metabolism have been reported throughout the pediatric age range. Our aim is to characterize both intestinal and hepatic CYP3A-mediated metabolism of midazolam in children in order to predict first-pass and systemic metabolism of CYP3A substrates. METHODS: Pharmacokinetic (PK) data of midazolam and 1-OH-midazolam from 264 post-operative children 1-18 years of age after oral administration were analyzed using a physiological population PK modelling approach...
July 30, 2018: Pharmaceutical Research
Adam P Ostendorf, Kelsey Merison, T Arthur Wheeler, Anup D Patel
BACKGROUND: Rapid, effective treatment for status epilepticus reduces associated morbidity and mortality, yet medication delivery remains slow in many hospitalized patients. We utilized quality improvement (QI) methodology to improve treatment times for hospitalized children with status epilepticus. We hypothesized rapid initial seizure treatment would decrease seizure morbidity. METHODS: We utilized QI and statistical process control analysis in a nonintensive care setting within a tertiary care pediatric hospital...
June 2, 2018: Pediatric Neurology
Alireza Mahdavi, Masoud Fallahinejad Ghajari, Ghassem Ansari, Leila Shafiei
Objectives: The aim of this study was to compare the intranasal premedication effect of newly introduced dexmedetomidine (DEX) versus midazolam on the behavior of uncooperative children in the dental clinic. Materials and Methods: This crossover double-blind clinical trial was conducted on 20 uncooperative children aged 2-6 years who required at least two similar dental treatment visits. The subjects were randomly given 1 μg/kg of DEX and 0.5 mg/kg of midazolam via the intranasal route...
March 2018: Journal of Dentistry of Tehran University of Medical Sciences
Mehmet Erdem Akçay, Ebru Tarıkçı Kılıç, Mehmet Salim Akdemir
Background: In this prospective, randomized study, we evaluated the intranasal administration of Midazolam ketamine combination, midazolam, and ketamine in premedication for children. Material and Methods: We studied 60 American Society of Anesthesiology physical status Classes I and II children aged between 1 and 10 years undergoing ear nose throat operations. All cases were premedicated 15 min before operation with intranasal administration of 0.2 mg/kg midazolam in Group M, 5 mg/kg Ketamine in Group K, and 0...
April 2018: Anesthesia, Essays and Researches
Hakan Akelma, Ebru Tarikçi Kiliç, Fikret Salik, Ayhan Kaydu
Objectives: To compare the effects of ketamine-fentanyl (KF) and ketamine-midazolam (KM) combinations on hemodynamic parameters, recovery properties, pain, and side effects in pediatric patients undergoing extracorporeal shock wave lithotripsy (ESWL) procedure. Methodology: In this double-blinded, randomized trial, 60 pediatric patients aged between 1 and 13 years with American Society of Anesthesiologists physical status Classes I and II, who scheduled for ESWL procedure, were included in the study...
April 2018: Anesthesia, Essays and Researches
Teppei Sago, Shunji Shiiba, Eika Ando, Kiriko Kondo, Misato Tsunakake, Sayaka Akitomi, Aya Ono, Yukari Kato, Yuki Chogyoji, Seiji Watanabe
Intravenous sedation (IVS) is commonly used to complete dental treatment for uncooperative pediatric patients. Propofol (PRO) is widely used for IVS because of its short context sensitive half-time and amnestic effect. However, administering PRO to patients who have a history of egg anaphylaxis is still somewhat controversial. The evidence that supports the potential risks for allergic reactions following PRO use in patients with egg allergies is limited with some anesthesiologists recommending against its use in these patients...
2018: Anesthesia Progress
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