Conscious sedation with high-dose midazolam for pediatric gastrointestinal endoscopy.
BACKGROUND
Midazolam is used frequently to sedate children for gastrointestinal endoscopy. The sedative dosage of intravenous midazolam commonly reported in children is up to 0.3 mg/kg. We hypothesized that larger doses of midazolam could be used for pediatric endoscopy.


METHODS
We retrospectively reviewed the medical records of 116 pediatric patients (aged 1 year to 18 years) who had endoscopy. The efficacy and side effects of sedation in 45 patients who received midazolam doses of > or = 0.3 mg/kg were compared with the same effects in 71 children who received < 0.3 mg/kg.


RESULTS
All patients received approximately 1 mg/kg meperidine (up to 50 mg) intravenously. The blood pressure, pulse rate, respiratory rate, oxygen saturation, degree and duration of sedation, and incidence of side effects such as hypotension, hypoxia, or vomiting were similar in both groups.


CONCLUSIONS
Intravenous doses of midazolam > 0.3 mg/kg can be used for conscious sedation in children.
Gremse
D A
DA
Division of Pediatric Gastroenterology and Nutrition, University of South Alabama College of Medicine, Mobile, USA.
Kumar
S
S
Sacks
A I
AI
D000293:Adolescent; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008874:Midazolam / Q000009:adverse effects / Q000627:therapeutic use*; D016343:Monitoring, Intraoperative
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam