title: Intranasal midazolam for anxiolysis in closed reduction of nasal fractures in children.
abstract: OBJECTIVE
  Nasal fractures can result in obstruction of the nasal airflow and cosmetic deformities, and are treated either with observation, closed reduction, or a delayed rhinoplasty. In the pediatric patient, closed reduction is challenging due to anxiety and poor patient cooperation. Here, we describe the unique topical use of intranasal midazolam for anxiolysis in two pediatric patients at the time of closed reduction of nasal fractures, which has not been previously described.
  
  
  METHODS
  Retrospective case series.
  
  
  RESULTS
  In this case series, intranasal midazolam was used in two pediatric patients with isolated nasal fractures during closed reduction for anxiolysis in the Emergency department at a single academic medical institution between 2012 and 2013. There were no adverse outcomes and anxiolysis was achieved in both patients.
  
  
  CONCLUSIONS
  Intranasal midazolam can provide effective anxiolysis for pediatric patients during closed reduction of nasal fractures.
authors.affiliation: Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA. Electronic address: pluma@upstate.edu.
authors.forename: Ann W
authors.initials: AW
authors.lastname: Plum
authors.affiliation: Arnot Health, Horseheads, NY, USA.
authors.forename: Tucker M
authors.initials: TM
authors.lastname: Harris
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D001007:Anxiety / Q000517:prevention & control*; D002648:Child; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D009295:Nasal Bone / Q000293:injuries*; D012189:Retrospective Studies; D012887:Skull Fractures / Q000628:therapy*
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam
keywords: Closed reduction; Intranasal midazolam; Nasal fracture