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Midazolam Pediatrics

Jing Xu, Reilley Paige Mathena, Shreya Singh, Jieun Kim, Jane J Long, Qun Li, Sue Junn, Ebony Blaize, Cyrus David Mintz
There is a large body of preclinical literature suggesting that exposure to general anesthetic agents during early life may have harmful effects on brain development. Patients in intensive care settings are often treated for prolonged periods with sedative medications, many of which have mechanisms of action that are similar to general anesthetics. Using in vivo studies of the mouse hippocampus and an in vitro rat cortical neuron model we asked whether there is evidence that repeated, long duration exposure to midazolam, a commonly used sedative in pediatric intensive care practice, has the potential to cause lasting harm to the developing brain...
January 2019: Journal of Neurosurgical Anesthesiology
Andrea Kresz, Benjamin Mayer, Maria Zernickel, Carsten Posovszky
Background and study aims  Use of carbon dioxide (CO 2 ) instead of room air (RA) during colonoscopy in adults revealed significantly less flatulence and abdominal pain in several studies. The objectives of this study were to investigate the effects of CO 2 usage on post-interventional pain, abdominal discomfort, abdominal girth, pCO 2 levels, and narcotic requirement in deeply sedated pediatric patients. Patients and methods  A total of 97 children and adolescents aged 4 years to 17 years undergoing colonoscopy were randomized to RA or CO 2 in a prospective, randomized, controlled trial...
February 2019: Endoscopy International Open
Athena F Zuppa, Daniela J Conrado, Nicole R Zane, Martha A Q Curley, Jonathan Bradfield, Hakon Hakonarson, Madeleine S Gastonguay, Ganesh Moorthy, Janice Prodell, Marc R Gastonguay
OBJECTIVES: To develop a pharmacokinetic-pharmacogenomic population model of midazolam in critically ill children with primary respiratory failure. DESIGN: Prospective pharmacokinetic-pharmacogenomic observational study. SETTING: Thirteen PICUs across the United States. PATIENTS: Pediatric subjects mechanically ventilated for acute respiratory failure, weight greater than or equal to 7 kg, receiving morphine and/or midazolam continuous infusions...
January 21, 2019: Critical Care Medicine
Lalida Kongkiattikul, Maryse Dagenais, Ni Ruo, Patricia Fontela, Tanya Di Genova, Samara Zavalkoff
OBJECTIVES: This study aims to assess the impact of a quality improvement initiative to increase assessments of pain, agitation, and iatrogenic withdrawal syndrome, on the use of sedative and analgesic medication in a pediatric intensive care unit. DESIGN AND SETTING: This is a retrospective pre- and post, observational, quality improvement study conducted in an eighteen-bed medical-surgical-cardiac, tertiary intensive care unit. PATIENTS: We included patients consecutively admitted from October 1- March 31 (pre period 2015-2016, post period 2016-2017) who were mechanically ventilated beyond 48 hours...
January 21, 2019: Paediatric Anaesthesia
Musa Shirmohammadie, Alireza Ebrahim Soltani, Shahriar Arbabi, Karim Nasseri
• Background: Caudal epidural is the most commonly used technique for the management of postoperative pain in children. The aim of the present study was to assess and compare the efficacy of caudal bupivacaine as a postoperative analgesic alone or combined with midazolam, ketamine, and neostigmine in pediatric patients undergoing lower abdominal surgery. METHODS: Eighty pediatric patients categorized under the American Society of Anesthesiologists Physical Status I and II Classification System, who have been scheduled to undergo lower abdominal surgery were randomly designated into four groups to receive caudal block with either 1 ml/kg of 0...
January 15, 2019: Acta Bio-medica: Atenei Parmensis
Sunjay Nunley, Peter Glynn, Steve Rust, Jorge Vidaurre, Dara V F Albert, Anup D Patel
RATIONALE: About 20 per 100,000 children have convulsive status epilepticus every year, a life-threatening condition. Benzodiazepines are the first-line treatment for prolonged and recurrent seizures. Our study was designed to gain understanding of caregiver perception of acute seizure treatments. METHODS: Our project uses a cross-sectional survey study design using the electronic medical record and a survey at a large academic tertiary children's medical center...
January 3, 2019: Epilepsy & Behavior: E&B
Lin Zhong, Kun Shen, Songhui Zhai, Ting Chen, Qingfen Tao, Lina Chen, Yuhong Tao, Li Qiu
This retrospective study investigated the application of the sedation-agitation scale (SAS) in pediatric bronchoscopy by observing its effects on sedative dosages and adverse reactions.Children who underwent sedation before bronchoscopy, during the period from January 2014 to June 2017, were divided into control and SAS groups. Patients in the control group were administered a single dose of 0.1 to 0.3 mg/kg midazolam, based on physicians' clinical experience. The initial dose of midazolam in the SAS group was 0...
January 2019: Medicine (Baltimore)
Asim Sadaf, Moorani N Khemchand, Lateef Fouzia, Zubair Asia
Renal biopsy is an important tool for the diagnosis of acute and chronic glomerular diseases in children. We aimed to analyze the spectrum of clinical indications and histopathological patterns (HPP) in children who underwent renal biopsy (RB). This is a retrospective review of case records of 108 renal biopsies carried out from January 2010 to December 2015 at the Pediatric Nephrology Department, National Institute of Child Health Karachi, Pakistan. RB was performed under Ketamine-Midazolam sedation and real-time ultrasound...
November 2018: Saudi Journal of Kidney Diseases and Transplantation
Majid Hajimaghsoudi, Mehdi Bagherabadi, Ehsan Zarepur, Vahid Ahmadi Hanzaei
Introduction: The quality of interventions in children is largely dependent on their control. Hence, this study compared the sedative effects of subcutaneous (SC) and intravenous (IV) Midazolam in pediatric sedation induction. Methods: This randomized clinical trial was conducted on children aged 1-6 years presenting to emergency departments of Shahid Sadoughi and Shahid Rahnemoon Hospitals, Yazd, Iran. Participants were randomly assigned to IV or SC midazolam using a jet injector and success rate, degree of sedation, and satisfaction of parents and physician were compared between groups...
2018: Emergency (Tehran, Iran)
James H Hertzog, Krista Preisberga, Scott Penfil
BACKGROUND AND OBJECTIVES: Anaphylaxis is rare but life-threatening. Its incidence during pediatric procedural sedation outside of the operating room is unknown. We used data from the Pediatric Sedation Research Consortium (PSRC) to determine the incidence and nature of allergic and anaphylactic reactions in this practice. METHODS: A retrospective observational study of prospectively collected information in the PSRC's multicenter database was performed. Cases of allergic reaction were identified...
January 2019: Hospital Pediatrics
Sedigheh Mozafar, Majid Bargrizan, Mojtaba Vahid Golpayegani, Shahnaz Shayeghi, Rahil Ahmadi
Background: This study compared the safety and efficacy of nitrous oxide (N2 O)/midazolam and N2 O/promethazine for dental treatment of uncooperative children. Materials and Methods: In this randomized, cross-over, clinical trial investigation Eighteen healthy uncooperative children with a pair of similar teeth requiring the same treatment were included. Combination of N2 O/midazolam was given in one visit, where N2 O/promethazine was administrated in the other appointment for each patient in a cross-over manner...
November 2018: Dental Research Journal
Palita Arayakarnkul, Krisnachai Chomtho
BACKGROUND: Super-refractory status epilepticus (SRSE) is a seizure that continues >24 h after anesthesia, or recurs on the reduction of anesthesia. SRSE is extremely difficult-to-control and associated with poor outcome. To date, optimal therapy and outcome data in children is limited. OBJECTIVE: To assess etiology, treatment options and outcome in pediatric SRSE patients. METHOD: We reviewed medical records of children <15 years old with SRSE during 2007-2017 at King Chulalongkorn Memorial Hospital...
December 7, 2018: Brain & Development
Asma Djabri, Richard H Guy, M Begoña Delgado-Charro
Drug delivery to the neonatal and premature pediatric populations is very challenging. This research assessed the potential of delivering midazolam by transdermal iontophoresis as an alternative strategy in pediatric therapy. In vitro experiments used intact and tape-stripped porcine skin as models for the skin barrier function of full-term and premature newborns, respectively. Midazolam transdermal transport was significantly enhanced by applying higher currents, increasing the formulation pH, and optimizing the drug's mole fraction in the vehicle...
November 29, 2018: European Journal of Pharmaceutical Sciences
Shin-Ichiro Hamano, Kenji Sugai, Masuo Miki, Toshiyuki Tabata, Takako Fukuyama, Makiko Osawa
BACKGROUND: No dosing regimen has been established for the initial treatment of pediatric status epilepticus with intravenous midazolam. We therefore evaluated the efficacy, safety, and pharmacokinetics of bolus and continuous midazolam infusion. METHODS: This open-label, prospective, multicenter study involved 34 Japanese children with status epilepticus unresponsive to diazepam. An initial bolus of 0.15 mg/kg midazolam was given, with additional doses of 0.1-0...
October 4, 2018: Journal of the Neurological Sciences
Selma Çakmakcı, Turan Bayhan, Meriç Kaymak Cihan, İnci Ergürhan İlhan
No abstract text is available yet for this article.
September 2018: Türk Pediatri Arşivi
Sylvia Kramer, Martin Krebs, Claudia Spies, Shahab Ghamari, Claudia Höhne, Karin Becke, Christoph Eich, Andreas Hoeft, Julius Wermelt, Richard K Ellerkmann
The upcoming and ongoing debate on neurotoxicity of anesthetics at a young age put a new spotlight on the emergence delirium of children (paedED). The European Society for Anesthesiology published a consensus guideline on prevention and therapy in 2017 which can be a useful guidance in daily clinical practice. Patient data management systems with their clear documentation concerning pain/therapy of pain and paedED will be valuable tools in order to assess the real incidence of paedED. Differentiating between pain/agitation and paedED migth not always be easy...
November 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Majid Mehran, Ghassem Ansari, Mojtaba Vahid Golpayegani, Shahnaz Shayeghi, Leila Shafiei
Background. The aim of this investigation was to compare the sedative effects of oral midazolam/chloral hydrate and midazolam/promethazine combinations on fearful children needing dental treatment. Methods. This crossover double-blind clinical trial was conducted on 30 children aged 2‒6 years, who had at least two similar teeth needing pulp treatment. Standard vital signs were recorded before and after premedication. Wilson sedation scale was used to judge the level of sedation. Cases were divided into two groups based on the sequence of medication received...
2018: Journal of Dental Research, Dental Clinics, Dental Prospects
Itai Shavit, Danielle Shavit, Oren Feldman, Nir Samuel, Anat Ilivitzki, Daniel M Cohen
BACKGROUND: Ileocolic intussusception is a major cause for intestinal obstruction in early childhood. Reduction of intussusception, in the vast majority of institutions, is performed on awake children, without sedation. OBJECTIVE: The aim of this study was to report the course of the first patients who were sedated by emergency physicians for pneumatic reduction of intussusception (PRI). METHODS: We conducted a case series analysis of prospectively collected data on patients undergoing PRI, using a sedation recording tool...
October 30, 2018: Journal of Emergency Medicine
Natalie C Luehmann, Michelle E Staubach, Begum Akay, Phillip J Collier, Richard E Han, Thomas W Riggs, Nathan M Novotny
BACKGROUND/PURPOSE: We initiated a pediatric surgical program including a caregiver for the induction of anesthesia. We measured preoperative midazolam administration, preoperative time, induction time, and program satisfaction. METHODS: Families with children undergoing surgery during the study period were included. Preoperative midazolam administration, preoperative time, and induction time were compared between participants and controls. Satisfaction surveys were given to participating caregivers and staff...
January 2019: Journal of Pediatric Surgery
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