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document
Intramuscular compared to intravenous midazolam for paediatric sedation : A study on cardiopulmonary safety and effectiveness . BACKGROUND Sedation in children remains a controversial issue in emergency departments ( ED ) . Midazolam , as a benzodiazepine is widely used for procedural sedation among paediatrics . We compared the effectiveness and safety of two forms of midazolam prescription ; intramuscular ( IM ) and intravenous ( IV ) . PATIENTS AND METHODS A cohort study was conducted on two matched groups of 30 children referred to our ED between 2010 and 2011 . The first group received IM midazolam ( 0.3 mg/kg ) and the second group received IV midazolam ( 0.15 mg/kg ) for sedation . For evaluating effectiveness , sedation , irritation and cooperation score were followed every 15 min for 60 min and for safety assessment , vital signs and O 2 saturation were observed . RESULTS Mean age was 6.18 ± 2.88 years and 31 patients ( 51.7 % ) were male . All patients were sedated completely after using first dose . There was an overall complication rate of 68.3 % . 35 ( 58.3 % ) patients presented euphoria as the most common complication , but there was no statistical difference between the two groups ( P = 0.396 ) . Cases who received IV midazolam became sedated faster than those received IM midazolam ( P > 0.001 ) . The vital signs including heart rate , respiratory rate , systolic blood pressure and O 2 saturation changed significantly between and within groups during the sedation ( P < 0.05 ) . CONCLUSION Both forms of midazolam , IM and IV , are effective and safe for paediatric sedation in ED . Although the sedative with IV form might appear sooner , IM form of midazolam can be effectively used in patient with limited IV access . Patients are better to observe closely for psychological side-effects .
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Intervention_Pharmacological
Intramuscular compared to intravenous midazolam
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Intervention_Pharmacological
Midazolam
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Intervention_Pharmacological
benzodiazepine
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Intervention_Pharmacological
midazolam prescription ; intramuscular ( IM ) and intravenous ( IV ) .
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Intervention_Pharmacological
IM midazolam
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Intervention_Pharmacological
IV midazolam
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Outcome_Physical
effectiveness
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Outcome_Physical
sedation
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Outcome_Mental
irritation and cooperation score
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Outcome_Physical
safety assessment , vital signs and O 2 saturation
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Outcome_Other
were sedated
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Outcome_Other
an overall complication rate
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Outcome_Adverse-effects
presented euphoria
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Outcome_Other
became sedated
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Outcome_Physical
including heart rate , respiratory rate , systolic blood pressure and O 2 saturation
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Outcome_Other
are effective and safe
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Participant_Age
children
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Participant_Sample-size
30
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Participant_Condition
ED between 2010 and 2011
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Participant_Age
Mean age was 6.18 ± 2.88 years
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Participant_Sample-size
31
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Participant_Sex
male