Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study.
BACKGROUND
Sedation with midazolam facilitates the performance of diagnostic procedures in children, including voiding cystourethrography (VCUG). However, the influence of sedation on voiding and imaging results have not been adequately evaluated.


OBJECTIVE
Midazolam and placebo were compared to assess discomfort during VCUG and to evaluate if sedation influenced the outcome of the examination.


METHODS
The study was prospective, randomised and double-blind, and included 95 children, 48 in the midazolam group (median age 2.2 years) and 47 in the placebo group (median age 3.2 years). The evaluation included the child's/parent's experience of the VCUG, as well as the examination results.


RESULTS
The children/parents in the midazolam group experienced the VCUG as less distressing compared to those in the placebo group ( P<0.001). Forty-six of 48 children sedated with midazolam could void during the imaging procedure compared to 38 of 47 children given placebo ( NS). There was no difference in frequency or grade of vesicoureteric reflux or bladder emptying between the groups.


CONCLUSIONS
When sedation is required to perform VCUG in children, midazolam can be used without negative effect on the outcome of the examination.
Stokland
Eira
E
Department of Paediatric Radiology and Clinical Physiology, The Queen Silvia Children's Hospital, 41685 Gothenburg, Sweden. eira.stokland@vgregion.se
Andréasson
Svenerik
S
Jacobsson
Bo
B
Jodal
Ulf
U
Ljung
Barbro
B
D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D003287:Contrast Media; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D011446:Prospective Studies; D011859:Radiography; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
D003287:Contrast Media; D006993:Hypnotics and Sedatives; D008874:Midazolam