Sedating children safely and effectively for minor
laceration repair is a well-recognized clinical problem. A randomized, double-blind, and controlled study was conducted to evaluate the efficacy of intranasal
midazolam for reducing stress during the suturing of
lacerations in preschool children. Fifty-nine children with simple
lacerations that required suturing were randomly assigned to one of three groups. Group 1 received intranasal
midazolam, 0.4 mg/kg, prior to suturing. Group 2 received an equivalent volume of
normal saline intranasally prior to suturing as a placebo. Group 3 was the control group and received no intervention prior to suturing. Heart rate, respiratory rate, blood pressure, and pulse oximetry were monitored at 5-minute intervals throughout the procedure. Subjective variables were also measured at 5-minute intervals and included a cry score, a motion score, and a struggle score. Parent satisfaction was measured via a short telephone interview the following day. There were no significant differences in outcome between the placebo group and the control group. Their results were pooled and compared with the results for the
midazolam group. The
midazolam group showed significant reductions for mean heart rate, maximum heart rate, and maximum systolic blood pressure when compared with the placebo/control group. Scores for two of the three subjective variables, cry and struggle, were significantly reduced for the
midazolam group. The papoose board was considered unnecessary in retrospect for more than half of patients in the
midazolam group compared with only one fifth of patients in the placebo/control group.(ABSTRACT TRUNCATED AT 250 WORDS)