Midazolam for urethral catheterisation in female infants with suspected urinary tract infection: a case-control study

Shavit, Itai; Feraru, Liat; Miron, Dan; Weiser, Giora

doi:10.1136/emermed-2012-202088

Cited by 4 publications

(6 citation statements)

References 9 publications

(4 reference statements)

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“…According to the ED protocol, if the child was older than 4 months of age, had an American Society of Anesthesiologists (ASA) physical status classification of 2 or less, and had been fasting for more than 1 h, he/she and his/her parents were offered the option of oral premedication by the treating physician. If the patient refused the oral route, he/she was treated intranasally [6]. Exclusion criteria included an ill-appearing child, ASA score of more than 2, fasting time of less than 1 h, previous sedation with midazolam, any known chronic condition, or if the child was not accompanied by his/her parent(s) [6].…”

Section: Selection Of Study Participantsmentioning

confidence: 99%

“…If the patient refused the oral route, he/she was treated intranasally [6]. Exclusion criteria included an ill-appearing child, ASA score of more than 2, fasting time of less than 1 h, previous sedation with midazolam, any known chronic condition, or if the child was not accompanied by his/her parent(s) [6].…”

Section: Selection Of Study Participantsmentioning

confidence: 99%

“…On the basis of these guidelines, in the pediatric ED of the Rambam Health Care Campus (RHCC), young children are commonly treated with midazolam before UC [6].…”

Section: Introductionmentioning

confidence: 99%

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Premedication with midazolam for urethral catheterization of febrile infants

Weiser¹,

Cohen²,

Krauss³

et al. 2014

European Journal of Emergency Medicine

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Febrile infants undergoing urethral catheterization (UC) are often not treated for pain and distress. The aim was to evaluate the effectiveness of midazolam premedication. We compared a convenience sample of infants who underwent UC with midazolam with those who did not receive midazolam. Outcome measures were Visual Analog Scale assessment, duration of cry, and emergency department length of stay. Thirty-two study participants and 18 controls were prospectively enrolled. Midazolam premedication showed a 53% decrease in the mean Visual Analog Scale score when parents assessed distress (33.6 vs. 71.7, P<0.0001) and a 48% decrease when nurses assessed distress (28.7 vs. 55.5, P<0.0002); the median cry duration was significantly shorter (0 vs. 240 s). Serious adverse events were not observed during sedation and at 48 h after discharge. Study participants had longer emergency department length of stay compared with the controls (191.5 vs. 139 min, P<0.017). In this cohort, midazolam significantly reduced the distress associated with UC without causing serious adverse events.

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Section: Selection Of Study Participantsmentioning

confidence: 99%

Section: Selection Of Study Participantsmentioning

confidence: 99%

See 1 more Smart Citation

Premedication with midazolam for urethral catheterization of febrile infants

Weiser¹,

Cohen²,

Krauss³

et al. 2014

European Journal of Emergency Medicine

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“…Inhaled nitrous oxide can make both catheters and SPAs less difficult in this age group. Oral midazolam is also useful for urine collection . We recommend the use of concentrated i.v.…”

Section: How Can I Make An Invasive Urine Test Less Traumatic For Thementioning

confidence: 99%

“…Oral midazolam is also useful for urine collection. 8,9 We recommend the use of concentrated i.v. preparation (5 mg/ mL) given orally, mixed with juice to disguise the taste.…”

Section: How Can I Make An Invasive Urine Test Less Traumatic For Thementioning

confidence: 99%

Urine collection in young children

Cheek

Craig

Seith

et al. 2015

Emerg Medicine Australasia

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Intranasal Fentanyl and Midazolam for Procedural Analgesia and Anxiolysis in Pediatric Urgent Care Centers

et al. 2019

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Objectives Intranasal fentanyl and midazolam use is increasing in the acute care setting for analgesia and anxiolysis, but there is a lack of literature demonstrating their use, alone or in combination, at pediatric urgent care centers. Methods This retrospective study investigated intranasal fentanyl and midazolam use at an urgent care center located within Le Bonheur Children's Hospital and 2 affiliated off-site centers from September 22, 2011, to December 30, 2015. Data collected included patient demographics, initial fentanyl dose, initial midazolam dose, type of procedure, and serious adverse drug reactions. Results Of the 490 patients who met the inclusion criteria, 143 patients received intranasal fentanyl alone, 92 received intranasal midazolam alone, and 255 received fentanyl in combination with midazolam. The overall patient population was 50% male with a median (range) age of 4.5 (0.2–17.9) years, and most patients were black at 57.1%. The median (range) initial intranasal fentanyl dose was 2.02 (0.99–4.22) μg/kg, and the median initial (range) intranasal midazolam dose was 0.19 (0.07–0.42) mg/kg. In cases where fentanyl and midazolam were administered in combination, the median (range) initial fentanyl dose was 2.23 (0.6–4.98) μg/kg and median (range) initial midazolam dose was 0.2 (0.03–0.45) mg/kg. There were no serious adverse drug reactions reported. Conclusions Intranasal fentanyl and midazolam when administrated alone and in combination can provide analgesia and anxiolysis for minor procedures in pediatric patients treated in the urgent care setting.

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Midazolam for urethral catheterisation in female infants with suspected urinary tract infection: a case-control study

Abstract: In this cohort of febrile infants, sedation with oral or intranasal midazolam reduced the risk of culture contamination during UC without causing serious adverse events. However, patients who were treated with sedation had longer length of stay in the ED.

Cited by 4 publications

References 9 publications

Premedication with midazolam for urethral catheterization of febrile infants

Premedication with midazolam for urethral catheterization of febrile infants

Urine collection in young children

Intranasal Fentanyl and Midazolam for Procedural Analgesia and Anxiolysis in Pediatric Urgent Care Centers

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