Abstract
Objective: To evaluate the feasibility of a sedation protocol based on Lidocaine spray and Intranasal Midazolam (INM) administered by Mucosal Atomizer Device (MAD) in uncooperative children undergoing minor painful procedures or diagnostic investigations.
Patients and design: Fourty-six children, aged 6-60 months, underwent INM (0.5 mg/kg) by MAD after delivering a puff of Lidocaine spray (10 mg per puff) before the execution of various procedures, such as peripheral line placements, venipunctures, intramuscular injections, heart ultrasound examinations, computed tomographic scans, auditory tests or dental manipulation. A questionnaire was designed to evaluate the effect of sedation in performing the procedures. Statistical analysis was performed to compare sedation times with age and weight of children tested.
Results: The degree of sedation achieved by INM allowed all procedures to be completed without any additional drugs. Premedication with Lidocaine spray prevented any nasal discomfort or pain related to INM. The mean duration of sedation effect was 23.1 minutes. No significant side effects could be recorded in the cohort of children studied. The degree of appreciation for both medical staff and children's parents was good. A significant correlation of effect start and end time was found only with age.
Conclusions: This study showed that the association of Lidocaine spray and atomized INM is safe and effective to obtain children's short-term sedation and to easily perform all the procedures.
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Chiaretti, A., Pierri, F., Barone, G. et al. 1362 Intranasal Lidocaine and Midazolam for Procedural Sedation in Children. Pediatr Res 68 (Suppl 1), 674 (2010). https://doi.org/10.1203/00006450-201011001-01362
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DOI: https://doi.org/10.1203/00006450-201011001-01362