Preanesthetic Sedation of Preschool Children Using Intranasal Midazolam

Wilton, Niall; Leigh, John E.; Rosen, David R.; Pandit, Uma A.

doi:10.1097/00000542-198812000-00032

Cited by 273 publications

(186 citation statements)

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“…Transmucosal routes of drug administration have been used as premedicants in this age group [6,7]. Intranasal midazolam has been found to be effective in doses ranging from 0.2 to 0.6 mg.kg )1 when used for conscious sedation and as a premedicant [8][9][10].…”

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confidence: 99%

The use of intranasal midazolam in the treatment of paediatric dental patients*

Gilchrist¹,

Cairns²,

Leitch³

2007

Anaesthesia

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SummaryThe aim of this study was to assess the use of intranasal midazolam in paediatric dental patients requiring extractions or simple surgical procedures who may otherwise have required a general anaesthetic. Twenty children aged between 2–9 years who required simple surgical procedures were given 0.25 mg.kg−1 midazolam, administered using a MAD® (Mucosal Atomization Device; Wolfe Tory Medical Inc., Salt Lake City, UT, USA). Compliance with the full dose was achieved in 14 patients, 13 of whom completed the treatment. One of two patients who allowed only partial administration completed the treatment and three patients did not comply. The mean time to starting treatment was 13 min (range 6–25 min) and patients were discharged after a mean of 46 min (range 25–67 min). Physiological parameters remained stable throughout with no clinically significant episodes of desaturation. One patient vomited at home postoperatively. Midazolam in a dose of 0.25 mg.kg−1 administered intranasally provided adequate anxiolysis for the majority of children, allowing them to complete their treatment.

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The use of intranasal midazolam in the treatment of paediatric dental patients*

Gilchrist¹,

Cairns²,

Leitch³

2007

Anaesthesia

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“…Previous studies have reported the occurrence of behavior changes 10-15 minutes after drug administration involving both the intramuscular 14 and intranasal 4 routes. In the current study, changes in behavior were evaluated based on the modified Houpt et al rating scale.…”

Section: Behavior Assessmentmentioning

confidence: 99%

“…As a water-soluble benzodiazepine, midazolam is nonirritating and has anxiolytic, sedative, hypnotic, and amnesic properties. Midazolam has been used as a preoperative sedative agent via the intramuscular, 1,2 intranasal, 3,4 oral, 5 and rectal 6 routes. A relatively slower onset of action is a disadvantage of both the oral and rectal routes of administration.…”

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confidence: 99%

“…Tolksdorf and Eick 7 found the oral route to be less predictable than the other routes studied, with patients experiencing nausea and vomiting postoperatively. Wilton et al 4 noted that oral midazolam also prolongs the recovery time when compared with other routes. Lejus et al 8 pointed out that although rectal midazolam is an effective premedication, a drawback relates to modesty issues associated with administering the drug rectally to older children.…”

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Midazolam Premedication in Children: A Pilot Study Comparing Intramuscular and Intranasal Administration

Lam¹,

Udin²,

Malamed³

et al. 2005

Anesthesia Progress

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The purpose of this study was to compare the effectiveness of intramuscular and intranasal midazolam used as a premedication before intravenous conscious sedation. Twenty-three children who were scheduled to receive dental treatment under intravenous sedation participated. The patients ranged in age from 2 to 9 years (mean age, 5.13 years) and were randomly assigned to receive a dose of 0.2 mg/kg of midazolam premedication via either intramuscular or intranasal administration. All patients received 50% nitrous oxide and 50% oxygen inhalation sedation and local anesthetic (0.2 mL of 4% prilocaine hydrochloride) before venipuncture. The sedation level, movement, and crying were evaluated at the following time points: 10 minutes after drug administration and at the times of parental separation, passive papoose board restraint, nitrous oxide nasal hood placement, local anesthetic administration, and initial venipuncture attempt. Mean ratings for the behavioral parameters of sedation level, degree of movement, and degree of crying were consistently higher but not significant in the intramuscular midazolam group at all 6 assessment points. Intramuscular midazolam was found to be statistically more effective in providing a better sedation level and less movement at the time of venipuncture than intranasal administration. Our findings indicate a tendency for intramuscular midazolam to be more effective as a premedication before intravenous sedation.

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“…A via de administração intranasal surge como uma alternativa em se evitar dor e ansiedade comparada à administração intramuscular, sendo utilizada em medicina pediátrica como uma via alternativa considerada segura e eficaz para administração de medicamentos (Wilton et al 1988, Rey et al 1991, Karl et al 1992, Bhakta et al 2007). Em medicina veterinária, a administração intranasal de anestésicos e suas combinações têm sido utilizadas em coelhos (Robertson 1994) e aves (Vesal & Eskandari 2006, Vesal & Zare 2006, Bigham & Moghaddam 2009, Moghadam et al 2009).…”

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Efeitos anestésicos da administração intranasal ou intramuscular de cetamina S+ e midazolam em pomba-rola (Streptotelia sp.)

et al. 2013

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Pesq. Vet. Bras. 33(4):517-522, abril 2013 517 RESUMO.-A via intranasal é uma boa alternativa por ser indolor e de fácil aplicação em aves. O objetivo deste estudo foi avaliar os efeitos anestésicos da associação de cetamina S+ e midazolam pela via intranasal (IN) The intranasal route is a good alternative because is painless and easy to perform in birds. The objective of this study was to evaluate the anesthetic effects of S+ ketamine and midazolam administered by intranasal or intramuscular route in pigeons. Twelve animals were used in a randomized and crossover design. Animals received two treatments with 2-weeks interval. IM group: animals received 20mg/kg of S+ ketamine and 3.5mg/kg of midazolam by intramuscular route (pectoral muscles); IN group: animals received the same protocol by intranasal route. Parameters evaluated were: onset of action, time of duration in dorsal recumbency; total time of anesthesia and side effects. Statistical analysis was performed using Wilcoxon test and the differences were considered significant when P<0. 05 IN (15 [4,5]) comparado ao IM (32 [28,[25][26][27][28][29][30][31][32][33][34][35][36][37][38]25] minutos). Dois animais de cada

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Preanesthetic Sedation of Preschool Children Using Intranasal Midazolam

Cited by 273 publications

References 0 publications

The use of intranasal midazolam in the treatment of paediatric dental patients*

The use of intranasal midazolam in the treatment of paediatric dental patients*

Midazolam Premedication in Children: A Pilot Study Comparing Intramuscular and Intranasal Administration

Efeitos anestésicos da administração intranasal ou intramuscular de cetamina S+ e midazolam em pomba-rola (Streptotelia sp.)

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