The effect of oral midazolam on anxiety of preschool children during laceration repair

Halim M. Hennes, Virginia Wagner, William A. Bonadio, Peter W. Glaeser, Joseph D. Losek, Christine M. Walsh-Kelly, Douglas S. Smith

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Preschool age children often experience marked anxiety and physical pain during laceration repair. Locally infiltrated anesthetics or topical tetracaine, adrenaline, and cocaine (TAC) usually control the physical pain but have little or no effect on anxiety. Midazolam is a short-acting benzodiazepine with anxiolytic, hypnotic, and antegrade amnestic effects. In a double-blind, randomized clinical trial, we evaluated the efficacy of midazolam in alleviating anxiety during laceration repair in children less than 6 years old. On admission to the emergency department, anxiety level was determined on a scale of 1 to 4 based on a predetermined behavior criteria. Patients with high anxiety level (3 or 4) received a single oral dose of either midazolam (0.2 mg/kg) or placebo. The anxiolytic effect of midazolam was considered adequate if the anxiety level decreased two or more points (from 4 to ≤ 2 or from 3 to 1) during laceration repair. In the midazolam group (30), 70% of the children had a two-point or more decrease in anxiety level compared with 12% in the placebo group (25) (P < .0001). No respiratory depression or other complications were noted in the midazolam group. We conclude that a single oral dose of midazolam (0.2 mg/kg) is a safe and effective treatment for alleviating anxiety in children less than 6 years old during laceration repair in the ED.

Original languageEnglish (US)
Pages (from-to)1006-1009
Number of pages4
JournalAnnals of Emergency Medicine
Volume19
Issue number9
DOIs
StatePublished - 1990

Fingerprint

Lacerations
Midazolam
Preschool Children
Anxiety
Anti-Anxiety Agents
Placebos
Tetracaine
Pain
Local Anesthetics
Hypnotics and Sedatives
Benzodiazepines
Cocaine
Respiratory Insufficiency
Epinephrine
Hospital Emergency Service
Randomized Controlled Trials

Keywords

  • midazolam

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Hennes, H. M., Wagner, V., Bonadio, W. A., Glaeser, P. W., Losek, J. D., Walsh-Kelly, C. M., & Smith, D. S. (1990). The effect of oral midazolam on anxiety of preschool children during laceration repair. Annals of Emergency Medicine, 19(9), 1006-1009. https://doi.org/10.1016/S0196-0644(05)82564-8

The effect of oral midazolam on anxiety of preschool children during laceration repair. / Hennes, Halim M.; Wagner, Virginia; Bonadio, William A.; Glaeser, Peter W.; Losek, Joseph D.; Walsh-Kelly, Christine M.; Smith, Douglas S.

In: Annals of Emergency Medicine, Vol. 19, No. 9, 1990, p. 1006-1009.

Research output: Contribution to journalArticle

Hennes, HM, Wagner, V, Bonadio, WA, Glaeser, PW, Losek, JD, Walsh-Kelly, CM & Smith, DS 1990, 'The effect of oral midazolam on anxiety of preschool children during laceration repair', Annals of Emergency Medicine, vol. 19, no. 9, pp. 1006-1009. https://doi.org/10.1016/S0196-0644(05)82564-8
Hennes, Halim M. ; Wagner, Virginia ; Bonadio, William A. ; Glaeser, Peter W. ; Losek, Joseph D. ; Walsh-Kelly, Christine M. ; Smith, Douglas S. / The effect of oral midazolam on anxiety of preschool children during laceration repair. In: Annals of Emergency Medicine. 1990 ; Vol. 19, No. 9. pp. 1006-1009.
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