Atomised intranasal midazolam spray as premedication in pediatric patients: comparison between two doses of 0.2 and 0.3 mg/kg

Abstract

Atomised midazolam at 0.3 mg/kg is safe, and achieves faster sedation and better separation scores as compared to 0.2 mg/kg.

Intranasal midazolam for anxiolysis in closed reduction of nasal fractures in children

“…There were no desaturations noted on continuous oximetry and both patients were able to handle their secretions and maintain gag reflexes. This is in agreement with prior studies concerning intranasal midazolam in dental procedures, with small numbers of patients having emesis, nasal secretions and conjunctival congestion [2,4].…”

“…This is in agreement with the success seen with intranasal midazolam in the first patient of this case series who had nasal obstruction. In addition, intranasal midazolam has a rapid onset, with studies reporting average onset times between 6.8 and 15 min [1,2,4]. This was corroborated by the above cases as a period of 15 min allowed for both patients.…”

“…The intranasal formulation has several advantages, including a higher bioavailability (76-92%) compared to the oral form (15-27%) and lack of degradation by the liver via the first pass effect [1][2][3]. The intranasal form is absorbed by the mucosa of the nose, which is important in patients with nasal fractures, as nasal obstruction should not hinder its delivery [1].…”

“…Topical intranasal midazolam has been used successfully to reduce preoperative anxiety and increase cooperation of pediatric patients in laceration repairs, dental procedures, imaging studies and prior to induction of general anesthesia [1][2][3][4][5][6][7]. However, there are no reports on the use of intranasal midazolam for reduction of isolated nasal bone fractures.…”

Lidocaine Pretreatment Reduces the Discomfort of Intranasal Midazolam Administration: A Randomized, Double‐blind, Placebo‐controlled Trial

“…Our study is the first to rigorously demonstrate the efficacy of topical lidocaine in decreasing the discomfort associated with IN midazolam administration. IN midazolam has many uses for anxiolysis and sedation in the ED as well as other clinical milieus . For an already anxious pediatric patient, administering a painful medication can exacerbate an already tense clinical situation.…”