Intramuscular Midazolam for Pediatric Sedation in the Emergency Department: A Short Communication on Clinical Safety and Effectiveness

Background: Procedural sedation in children continues to be a problem in the emergency department (ED). Midazolam is the first water-soluble benzodiazepine and it has been widely used for procedural sedation in pediatric patients. Objectives: The aim of this study was evaluation of clinical safety and effectiveness of intramuscular Midazolam for pediatric sedation in the ED setting. Materials and Methods: We performed a self-controlled clinical trial on ۳۰ children who referred to the Baqiyatallah Hospital ED between ۲۰۰۹ and ۲۰۱۰. They received intramuscular Midazolam ۰.۳ mg/kg for procedural sedation and then they were followed for sedative effectiveness and safety. Vital signs and O۲ saturation were also observed. The findings were compared using SPSS ver. ۱۶ software. Results: The mean age was ۵.۵۰ ± ۲.۷۰ years, the mean weight was ۱۹.۵۰ ± ۶.۶۳ kilograms and ۱۶ patients (۵۳.۳%) were females. The most common adverse effect was euphoria (۶۶.۶۶%) and vertigo (۶.۷%); ۲۷.۷% did not show any side effects. There was an overall complication rate of ۷۲.۳%. The vital signs including heart rate, respiratory rate, systolic and diastolic blood pressure and O۲ saturation decreased significantly during sedation (P value < ۰.۰۵). Conclusions: Midazolam is an effective and relatively safe sedative for pediatric patients in the ED. The patient should be observed closely and monitored for psychological and hemodynamic side effects.

Keywords:

Injections , Intramuscular , Midazolam , safety , Sedation , Euphoria