title: Premedication with midazolam for urethral catheterization of febrile infants.
abstract: Febrile infants undergoing urethral catheterization (UC) are often not treated for pain and distress. The aim was to evaluate the effectiveness of midazolam premedication. We compared a convenience sample of infants who underwent UC with midazolam with those who did not receive midazolam. Outcome measures were Visual Analog Scale assessment, duration of cry, and emergency department length of stay. Thirty-two study participants and 18 controls were prospectively enrolled. Midazolam premedication showed a 53% decrease in the mean Visual Analog Scale score when parents assessed distress (33.6 vs. 71.7, P<0.0001) and a 48% decrease when nurses assessed distress (28.7 vs. 55.5, P<0.0002); the median cry duration was significantly shorter (0 vs. 240 s). Serious adverse events were not observed during sedation and at 48 h after discharge. Study participants had longer emergency department length of stay compared with the controls (191.5 vs. 139 min, P<0.017). In this cohort, midazolam significantly reduced the distress associated with UC without causing serious adverse events.
authors: aDepartment of Pediatric Emergency, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel bDepartment of Pediatrics, Division of Emergency Medicine, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA cEmergency Department, Alberta Children's Hospital, University of Calgary, Alberta, Canada.
authors: Giora
authors: G
authors: Weiser
authors: Dana
authors: D
authors: Cohen
authors: Baruch
authors: B
authors: Krauss
authors: Roger
authors: R
authors: Galbraith
authors: Itai
authors: I
authors: Shavit
mesh_terms: D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D005334:Fever / Q000628:therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D059408:Pain Management; D010147:Pain Measurement; D011292:Premedication / Q000379:methods; D014546:Urinary Catheterization / Q000379:methods*
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam