Midazolam Articles

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Midazolam Articles:

Kennedy RM, Porter FL, Miller JP, et al. Comparison of fentanyl/midazolam with ketamine/midazolam for pediatric orthopedic emergencies. Pediatrics. 1998;102:956-963.

Sherwin TS, Green SM, Khan A, et al. Does adjunctive midazolam reduce recovery agitation after ketamine sedation for pediatric procedures? A randomized, double-blind, placebo-controlled trial. Ann Emerg Med. 2000;35:239-244.

Parker RI, Mahan RA, Giugliano D, et al. Efficacy and safety of intravenous midazolam and ketamine as sedation for therapeutic and diagnostic procedures in children. Pediatrics. 1997;99:427-431.

Kennedy RM, Porter FL, Miller JP, et al. Comparison of fentanyl/midazolam with ketamine/midazolam for pediatric orthopedic emergencies. Pediatrics. 1998;102:956-963.

Comment: During emergency orthopedic procedures K/M works better than F/M to relieve anxiety and pain. Respiratory emergencies occur more often with F/M. Both regimens facilitate reduction, produce amnesia and rarely cause delirium. Vomiting is more frequent and recovery more prolonged with K/M.

Havel CJ Jr. Strait RT. Hennes H. A clinical trial of propofol vs midazolam for procedural sedation in a pediatric emergency department . Academic Emergency Medicine. 6(10):989-97, 1999 Oct.

Comment: A prospective blinded study comparing midazolam and propofol as sedative in addition to morphine in the emergency department. Propofol was effective and has a much shorter recovery time than midazolam. Brief periods of O2 desaturation were more common in the propofol group.

Chudnofsky CR. Safety and efficacy of flumazenil in reversing conscious sedation in the emergency department. Emergency Medicine Conscious Sedation Study Group. Acad Emerg Med. 1997 Oct; 4(10):944-50.

Slonim AD, Ognibene FP. Sedation for pediatric procedures, using ketamine and midazolam, in a primarily adult intensive care unit: a retrospective evaluation. Critical Care Medicine 26(11):1900-4, 1998.

Comment: Retrospective review. Nine complications encountered in 247 procedures performed with ketamine and midazolam. No cardiovascular compromise noted and none were admitted to the ICU. Conclusion is that sedation for painful procedures can be performed outside the OR by non-pediatricians. Limited side effects were noted.