Intranasal lidocaine and midazolam for procedural sedation in children

Antonio Chiaretti, Giuseppe Barone, Donato Rigante, Antonio Ruggiero, Filomena Pierri, Egidio Barbi, Giovanni Barone, Riccardo Riccardi

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Objective To evaluate the safety and efficacy of a sedation protocol based on intranasal lidocaine spray and midazolam (INM) in children who are anxious and uncooperative when undergoing minor painful or diagnostic procedures, such as peripheral line insertion, venipuncture, intramuscular injection, echocardiogram, CT scan, audiometry testing and dental examination and extractions. Patients and design 46 children, aged 5-50 months, received INM (0.5 mg/kg) via a mucosal atomiser device. To avoid any nasal discomfort a puff of lidocaine spray (10 mg/puff) was administered before INM. The child's degree of sedation was scored using a modified Ramsay sedation scale. A questionnaire was designed to evaluate the parents' and doctors' opinions on the efficacy of the sedation. Statistical analysis was used to compare sedation times with children's age and weight. Results The degree of sedation achieved by INM enabled all procedures to be completed without additional drugs. Premedication with lidocaine spray prevented any nasal discomfort related to the INM. The mean duration of sedation was 23.1 min. The depth of sedation was 1 on the modified Ramsay scale. The questionnaire revealed high levels of satisfaction by both doctors and parents. Sedation start and end times were significantly correlated with age only. No side effects were recorded in the cohort of children studied. Conclusions This study has shown that the combined use of lidocaine spray and atomised INM appears to be a safe and effective method to achieve short-term sedation in children to facilitate medical care and procedures.

Original languageEnglish
Pages (from-to)160-163
Number of pages4
JournalArchives of Disease in Childhood
Volume96
Issue number2
DOIs
Publication statusPublished - Feb 2011

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Midazolam
Lidocaine
Nose
Parents
Audiometry
Tooth Extraction
Phlebotomy
Premedication
Intramuscular Injections
Safety
Weights and Measures
Equipment and Supplies
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Chiaretti, A., Barone, G., Rigante, D., Ruggiero, A., Pierri, F., Barbi, E., ... Riccardi, R. (2011). Intranasal lidocaine and midazolam for procedural sedation in children. Archives of Disease in Childhood, 96(2), 160-163. https://doi.org/10.1136/adc.2010.188433

Intranasal lidocaine and midazolam for procedural sedation in children. / Chiaretti, Antonio; Barone, Giuseppe; Rigante, Donato; Ruggiero, Antonio; Pierri, Filomena; Barbi, Egidio; Barone, Giovanni; Riccardi, Riccardo.

In: Archives of Disease in Childhood, Vol. 96, No. 2, 02.2011, p. 160-163.

Research output: Contribution to journalArticle

Chiaretti, A, Barone, G, Rigante, D, Ruggiero, A, Pierri, F, Barbi, E, Barone, G & Riccardi, R 2011, 'Intranasal lidocaine and midazolam for procedural sedation in children', Archives of Disease in Childhood, vol. 96, no. 2, pp. 160-163. https://doi.org/10.1136/adc.2010.188433
Chiaretti, Antonio ; Barone, Giuseppe ; Rigante, Donato ; Ruggiero, Antonio ; Pierri, Filomena ; Barbi, Egidio ; Barone, Giovanni ; Riccardi, Riccardo. / Intranasal lidocaine and midazolam for procedural sedation in children. In: Archives of Disease in Childhood. 2011 ; Vol. 96, No. 2. pp. 160-163.
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