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 language | English |
|---|---|
| Pages (from-to) | 160-163 |
| Number of pages | 4 |
| Journal | Archives of Disease in Childhood |
| Volume | 96 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2011 |
Fingerprint
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
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 journal › Article
}
TY - JOUR
T1 - Intranasal lidocaine and midazolam for procedural sedation in children
AU - Chiaretti, Antonio
AU - Barone, Giuseppe
AU - Rigante, Donato
AU - Ruggiero, Antonio
AU - Pierri, Filomena
AU - Barbi, Egidio
AU - Barone, Giovanni
AU - Riccardi, Riccardo
PY - 2011/2
Y1 - 2011/2
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=78651463150&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78651463150&partnerID=8YFLogxK
U2 - 10.1136/adc.2010.188433
DO - 10.1136/adc.2010.188433
M3 - Article
VL - 96
SP - 160
EP - 163
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
SN - 0003-9888
IS - 2
ER -