Use of oral midazolam in pediatric upper gastrointestinal endoscopy.
BACKGROUND
The purpose of this prospective, randomized study was to compare the safety and efficacy of oral versus i.v. midazolam in providing sedation for pediatric upper gastrointestinal (GI) endoscopy.


METHODS
Sixty-one children (age <16 years) scheduled for upper GI endoscopy were studied. Patients were randomly assigned to receive oral or i.v. midazolam. Measurements were made and compared for vital signs, level of sedation, pre- and post-procedure comfort, anxiety during endoscopy, ease of separation from parents, ease and duration of procedure, and recovery time.


RESULTS
Patients were aged 1-16 years (mean 7.5 + or - 3.42 years); 30 patients received oral medication, and 31 received i.v. medication. There were no statistically significant differences in age or gender between groups. There were no significant differences in level of sedation, ease of separation from parents, ease of ability to monitor the patient during the procedure, heart rate, systolic arterial pressure, or respiratory rate. Oxygen saturation was significantly lower in the i.v. group than the oral group 10 and 30 min after removal of the endoscope, and recovery time was longer in the oral than the i.v. group.


CONCLUSIONS
Oral administration of midazolam is a safe and effective method of sedation that significantly reduces anxiety and improves overall tolerance for children undergoing esophagogastroduodenoscopy.
Rafeey
Mandana
M
Department of Pediatrics, Liver and Gastrointestinal Diseases Research Center, Iran. mrafeey@yahoo.com
Ghojazadeh
Morteza
M
Feizo Allah Zadeh
Hosain
H
Majidi
Hamideh
H
D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D011446:Prospective Studies; D016037:Single-Blind Method
D006993:Hypnotics and Sedatives; D008874:Midazolam