Oral midazolam for removal of Kirschner wires in the children's orthopaedic outpatient department: a randomized controlled trial.
BACKGROUND
Use of Kirschner wires (K-wires) is common in pediatric elbow fracture treatment. We investigate whether anxiety levels at removal of wires may be reduced using oral midazolam.


METHODS
This was a prospective randomized controlled trial with 2 groups, with midazolam and with placebo.


RESULTS
Forty-two children with an average age of 7.1 years (range, 3.6-12.3 y) had complete documentation for analysis. The change in anxiety scores was not significantly different between the 2 groups. Forty-five percent of children in the midazolam group had reduced anxiety levels compared with 18% of children given placebo, but this difference was not significant (P=0.102). The anxiety scores before and after wire removal in the midazolam group were not significantly different from the placebo group scores.


CONCLUSIONS
We do not recommend the routine administration of midazolam (0.2 mg/kg) to all children requiring K-wire removal in the outpatient department.


METHODS
I.
Templeton
Peter
P
Department of Orthopaedic Surgery, The General Infirmary at Leeds, Leeds, UK. Peter.templeton@leedsth.nhs.uk
Burton
David
D
Cullen
Eileen
E
Lewis
Heather
H
Allgar
Victoria
V
Wilson
Rowan
R
D000759:Adjuvants, Anesthesia; D000284:Administration, Oral; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy* / Q000209:etiology; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000379:methods*; D004311:Double-Blind Method; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D010045:Outpatients; D011446:Prospective Studies; D016896:Treatment Outcome; D000092464:Elbow Injuries
D000759:Adjuvants, Anesthesia; D014151:Anti-Anxiety Agents; D008874:Midazolam