Journals / The Journal of Pediatric Research / 2019 / Cilt: 6 - Sayı: 4

Efficacy and Safety of Intranasal Midazolam Versus Chloral Hydrate as Sedation for Quality Computed Tomography Imaging in Children

Pages
286–291
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The majority of parents were somewhat to very satisfied, 83.54% and 81.25% inthe OCH and INM groups, respectively (p=0.928).Conclusion: INM can be used to sedate children between 1 to 8 years who are to undergo CT imaging of brain with a comparable rate ofefficacy and safety to OCH.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: The purpose of this study was to compare the efficacy and safety of aerosolized intranasal midazolam (INM) compared to oral chloralhydrate (OCH) as procedural sedatives in pediatric patients undergoing computed tomography (CT) imaging.Materials and Methods: A prospective, randomized, double-blind clinical trial was utilized in children aged 1 to 8 years who presented tothe ED with minor head trauma and were scheduled to undergo brain CT scan.
📊
Key Findings & Data:One hundred and sixty children were randomized to receiveINM 0.3 mg/kg with oral placebo or 75 mg/kg OCH with intranasal placebo.
💡
Conclusion & Impact:The majority of parents were somewhat to very satisfied, 83.54% and 81.25% inthe OCH and INM groups, respectively (p=0.928).Conclusion: INM can be used to sedate children between 1 to 8 years who are to undergo CT imaging of brain with a comparable rate ofefficacy and safety to OCH.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Aim: The purpose of this study was to compare the efficacy and safety of aerosolized intranasal midazolam (INM) compared to oral chloralhydrate (OCH) as procedural sedatives in pediatric patients undergoing computed tomography (CT) imaging.Materials and Methods: A prospective, randomized, double-blind clinical trial was utilized in children aged 1 to 8 years who presented tothe ED with minor head trauma and were scheduled to undergo brain CT scan. One hundred and sixty children were randomized to receiveINM 0.3 mg/kg with oral placebo or 75 mg/kg OCH with intranasal placebo. If the patient was not adequately sedated 20 minutes afterthe initial dose, a second dose of the same medication at one-third of the initial dosage was given. The sedation level of patients after drugadministration was assessed using the Ramsay sedation scale.Results: Both groups were comparable with respect to age, male to female ratio, weight, and baseline vital signs. Sixty two children (77.50%)in the INM group and 59 children (73.42%) in the OCH groups reached a Ramsay score of four, respectively (p=0.55). There was no significantdifference in regards to the time to become adequately sedated (21.32±6.54 vs 23.62±7.40, p=0.173) and time for completing CT scan(30.37±7.18 vs 32.96±7.85, p=0.185). However, the time to recovery was shorter for the INM group (72.52±10.17 vs 88.10±10.27, p=0.001). Noserious side effects were seen in the study groups (p=0.836). The majority of parents were somewhat to very satisfied, 83.54% and 81.25% inthe OCH and INM groups, respectively (p=0.928).Conclusion: INM can be used to sedate children between 1 to 8 years who are to undergo CT imaging of brain with a comparable rate ofefficacy and safety to OCH.

🔖

Cite This Article

HEYDARİ, F., SHABANI, H., MAJIDINEJAD, S., NASR-ESFAHANI, M. (2019). Efficacy and Safety of Intranasal Midazolam Versus Chloral Hydrate as Sedation for Quality Computed Tomography Imaging in Children. The Journal of Pediatric Research, Cilt: 6 - Sayı: 4, 286–291. https://ajindex.com/articles/362766

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (15)

  1. Arlachov Y, Ganatra RH. Sedation/anaesthesia in paediatric radiology. Br J Radiol 2012;85:e1018-31
  2. Cravero JP, Blike GT, Beach M, et al. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics 2006;118:1087-96
  3. Bailey MA, Saraswatula A, Dale G, Softley L. Paediatric sedation for imaging is safe and effective in a district general hospital. Br J Radiol 2016;89:20150483
  4. Chokshi AA, Patel VR, Chauhan PR, Patel DJ, Chadha IA, Ramani MN. Evaluation of intranasal midazolam spray as a sedative in pediatric patients for radiological imaging procedures. Anesth Essays Res 2013;7:189-93
  5. Fallah R, Nakhaei MH, Behdad S, Moghaddam RN, Shamszadeh A. Oral chloral hydrate vs. intranasal midazolam for sedation during computerized tomography. Indian Pediatr 2013;50:233-5
  6. Kennedy RM, Luhmann JD. Pharmacological management of pain and anxiety during emergency procedures in children. Paediatric Drugs 2001;3:337-54
  7. Krauss B, Green SM. Procedural sedation and analgesia in children. Lancet 2006;367:766-80
  8. Macias CG, Chumpitazi CE. Sedation and anesthesia for CT: emerging issues for providing high-quality care. Pediatr Radiol 2011;41:517-22
  9. Majidinejad S, Taherian K, Esmailian M, Khazaei M, Samaie V. Oral midazolam-ketamine versus midazolam alone for procedural sedation of children undergoing computed tomography; a randomized clinical trial. Emerg (Tehran) 2015;3:64-9
  10. Azizkhani R, Kanani S, Sharifi A, Golshani K, Masoumi B, Ahmadi O. Oral chloral hydrate compare with rectal thiopental in pediatric procedural sedation and analgesia; a randomized clinical trial. Emerg (Tehran) 2014;2:85-9
  11. Sahyoun C, Krauss B. Clinical implications of pharmacokinetics and pharmacodynamics of procedural sedation agents in children. Curr Opin Pediatr 2012;24:225-32
  12. Baxter AL, Mallory MD, Spandorfer PR, et al. Etomidate versus pentobarbital for computed tomography sedations: report from the Pediatric Sedation Research Consortium. Pediatr Emerg Care 2007;23:690-5
  13. Keim SM, Erstad BL, Sakles JC, Davis V. Etomidate for procedural sedation in the emergency department. Pharmacotherapy 2002;22:586-92
  14. Buck ML. A Monthly Newsletter for Health Care Professionals from the University of Virginia Children’s Hospital. Pediatric Pharmacotherapy 2005;11
  15. Malviya S, Voepel-Lewis T, Prochaska G, Tait AR. Prolonged recovery and delay