title: Melatonin and intravenous midazolam administered orally in drug induced sleep electroencephalography of children: randomized clinical trial of efficacy.
abstract: BACKGROUND
  Electroencephalography (EEG) is a useful diagnostic tool in the diagnosis of seizure and differentiating it from seizure-like attacks. Cooperation and immobility of the patient is crucial and in children who do not naturally sleep, pharmacological agents and procedural sedation should be used for sleep inducement. The purpose of this study was to compare efficacy and safety of melatonin and intravenous solution of midazolam administered orally in sedation induction for EEG of children.
  
  
  METHODS
  In a parallel single-blinded randomized clinical trial, sixty 1 - 8 year old children who were referred to EEG Unit of Shahid Sadoughi Hospital, Yazd, Iran from September 2011 to March 2012 were evaluated. The Children were randomly assigned into two groups to receive orally 0.3 mg/kg melatonin or 0.75 mg/kg ampoule of midazolam. The primary outcome was efficacy in adequate sedation (Ramsay sedation score of four) and recording of EEG. Secondary outcome was clinical side effects.
  
  
  RESULTS
  Nineteen girls (31.7%) and 41 boys (68.3%) with the mean age of 2.8 ± 1.8 years were evaluated. Adequate  sedation  and  recording  of EEG was  achieved in  36.7% of  midazolam  group and  in 73.3%  of  melatonin group, (p = 0.004). Transient agitation was seen in 6.6% of midazolam group. No significant difference was observed from the viewpoint of side effects frequency between the two drugs, (p = 0.15).
  
  
  CONCLUSIONS
  Melatonin is a safe and an effective drug in sedation induction for EEG in children.
authors.affiliation: Department of Pediatrics, Children Growth Disorders Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. sakarbasi@yahoo.com.
authors.forename: Razieh
authors.initials: R
authors.lastname: Fallah
authors.affiliation: Department of Pediatrics, Children Growth Disorders Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Yadegari
authors.affiliation: Department of Anesthesia and Intensive Care, Research Center of Pain, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Shekofah
authors.initials: S
authors.lastname: Behdad
authors.affiliation: Department of Pediatrics, Children Growth Disorders Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Sedighah
authors.initials: S
authors.lastname: Akhavan Karbasi
mesh_terms: D000284:Administration, Oral; D002675:Child, Preschool; D016292:Procedural Sedation; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008550:Melatonin / Q000008:administration & dosage*; D008874:Midazolam / Q000008:administration & dosage*; D016037:Single-Blind Method; D012890:Sleep / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D008550:Melatonin; D008874:Midazolam