diazepam in child agitation

Intrarectal administration of a premedication in children eliminates the stress due to intramuscular injection. Diazepam rectal administration induces clearly heavier sedation compared to its parenteral administration. The place of midazolam in this mode of premedication has yet to be determined.

In a randomized, double-blind study of premedication in 69 infants aged between 13 and 48 months the effects of 0.82 mg/kg midazolam or diazepam rectally plus 2.0 mg/kg ketamine i.m., or the administration of 2.4 mg/kg ketamine i.m. alone was studied. A satisfying result of 94.1% following the premedication with midazolam/ketamine, of 82.9% with diazepam/ketamine and of 81.3% with ketamine alone was observed. Premedication with midazolam/ketamine was the best one in the review of vigilance, agitation, and behaviour of defence against the mask at the beginning of anaesthesia...

During 1984-1989, 19 Bedouin children, 4-8 years old, were hospitalized because of henbane plant (Hyoscyamus reticulatus) poisoning. There were 14 cases in the autumn, 3 in the spring and 2 in the summer. The most prominent signs were altered state of consciousness (including deep coma in 3) and flushed dry, warm skin in all. Pupils were dilated in 18 of the 19 and restlessness and hallucinations were present in 17. Less common were vomiting, increased tendon reflexes, convulsions, involuntary movements, ataxia, hypertension, hyperpyrexia and tachycardia...

A 3-year-old girl was stung by a scorpion (Androctonus bicolor bicolor) in her foot while walking barefoot in a courtyard in the early evening. Within an hour she began to vomit and became extremely agitated. On admission she was stuporous and hypotensive, and severe hypertonicity and prolonged convulsions ensued. Treatment consisted of adrenalin, corticosteroids, diazepam, chloral hydrate and phenobarbital and she improved within 2 hours. The following day myocardial involvement, with tachycardia, gallop rhythm and electrocardiographic abnormalities developed and treatment with digoxin and dexamethasone was started...

Midazolam is a new imidazobenzodiazepine derivative that is two to three times as potent as diazepam, is water-soluble, has a rapid onset and short duration of action, and produces a profound amnestic effect. These properties make it an extremely useful drug for outpatient sedation. We performed retrospective review of midazolam use in a general emergency department over a one-year period. Midazolam was used in 120 patients, 71 men and 49 women, with an average age of 46 years. The average dose given was 3...

We compared the effects of rectally administered diclofenac (12.5 mg) with paracetamol (125 mg) on pre- and postoperative behaviour and the need for supplementary analgesia in 44 children scheduled for adenoidectomy (with or without myringotomy). The study drugs were given in combination with diazepam (0.5 mg.kg-1) about 20 min before the children were taken to the operating theatre. On arrival there, the children who had received diclofenac were significantly quieter (< 0.05), easier to handle (p < 0...

In nine cases of phencyclidine hydrochloride poisoning, early signs of overdose included drowsiness, nystagmus, miotic pupils, blood pressure elevation, increased deep tendon reflexes, ataxia, anxiety, and agitation. In more severe cases, seizures, spasticity, and opisthotonos were seen in addition to deep coma and respiratory depression. Treatment included removal by emetics or lavage, hydration, and a quiet, reassuring environment. Spasticity, agitation, and ocular manifestions responded to diazepam. Psychiatric intervention was instituted after the patients were stable and no longer agitated...

One of four groups of patients was not premedicated; the others received diazepam 10 mg by mouth, diazepam 20 mg by mouth or a combination of pentobarbitone orally and morphine and hyoscine intramuscularly. The cardiovascular and respiratory parameters were studied before and after the premedication and any changes in sedation, apprehension and reaction to pain were noted. The ease of induction of anaesthesia in the four groups was compared. Most of the patients who received the pentobarbitone, morphine and hyoscine combination came to theatre calm, sedated and often asleep...