May 1, 1993

Transmucosal administration of midazolam for premedication of pediatric patients. Comparison of the nasal and sublingual routes

Helen W KarlJ M Ruffle


Nasal transmucosal midazolam is effective for premedication of pediatric patients; however, 61-74% of these patients cry at nasal drug administration. Sublingual benzodiazepines, including midazolam, are effective in adults. The current blinded randomized study compared acceptance of and behavioral responses to transmucosal midazolam administered via the intranasal and sublingual routes. Ninety-three patients aged 0.5-10 yr were stratified by age: 30 infants and toddlers, 0.5-2 yr; 39 preschoolers, 2.1-5 yr; and 24 school age, 5.1-10 yr. They were randomized to receive 0.2 mg/kg of midazolam in the nose or under the tongue without or with additional flavoring. For the group receiving sublingual flavored midazolam, the syringe tip was dipped in candy flavor and sugar. Duration of crying and compliance with instructions for sublingual drug administration were recorded. Hemoglobin oxygen saturation by pulse oximetry and sedation score were recorded by three observers before drug administration, at 2.5-min intervals for 10 min, at separation from parents, and during induction with halothane in O2. Children accepted midazolam administered via the sublingual route better than that given intranasally. In children not crying before dru...Continue Reading

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Mentioned in this Paper

Health Care Seeking Behavior
Transmucosal Route of Drug Administration
Absence of Sensation
Drug Effect Disorder
Drug Effect
Benign Neoplasm of Tongue

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