title: Evaluation of intranasal midazolam in refraction and fundus examination of young children with strabismus.
abstract: OBJECTIVE
  To determine the clinical sedative effect and dosage of intranasal midazolam in refraction and fundus examination of children with strabismus.
  
  
  METHODS
  Refraction and fundus examination with (n = 28) and without (n = 24) sedation were performed in 52 children with strabismus whose ages ranged from 7 to 26 months. We delivered a 5-mg/mL solution of midazolam via a syringe for 60 seconds to provide a dose of 0.2 mg/kg. We repeated the dose to a maximum of 0.3 mg/kg if there was no clinical sedative response after 10 to 15 minutes. The ease of examination and sedation for each patient was scored by a blinded observer. The groups were evaluated for ease of examination and the time needed to complete it.
  
  
  RESULTS
  We obtained clinically adequate sedation at a mean (+/- standard deviation) of 15 minutes (+/- 2.69 minutes). Sedation was achieved with a mean dose of 2.64 mg/kg (+/- 0.66 mg/kg). Children receiving midazolam had significantly calmer examination scores. The time needed to complete the examination was statistically significantly shorter for these children than for children not receiving sedation (P < .05).
  
  
  CONCLUSIONS
  Intranasal midazolam is a beneficial drug and method of delivery for the sedation of anxious children with strabismus undergoing refraction and fundus examination. Sedation prior to examination is effective in reducing the anxiety and time associated with ophthalmologic examination of children with strabismus.
authors.affiliation: Department of Ophthalmology, Kocaeli University School of Medicine, Izmit, Kocaeli, Turkey.
authors.forename: Ozgül
authors.initials: O
authors.lastname: Altintas
authors.forename: V Levent
authors.initials: VL
authors.lastname: Karabas
authors.forename: Göktug
authors.initials: G
authors.lastname: Demirci
authors.forename: Inci
authors.initials: I
authors.lastname: Onur
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Caglar
mesh_terms: D000281:Administration, Intranasal; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods*; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007223:Infant; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D011446:Prospective Studies; D012029:Refraction, Ocular; D013285:Strabismus / Q000175:diagnosis*
chemical_list: D014151:Anti-Anxiety Agents; D008874:Midazolam