25
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Oral Midazolam for Voiding Dysfunction in Children Undergoing Voiding Cystourethrography: A Controlled Randomized Clinical Trial

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background:

          Voiding Cystourethrography (VCUG) is the gold standard of detecting and grading the vesicoureteral reflux. Moreover, VCUG is a part of the standard review for infants and children with a urinary tract infection and urinary dysfunction.

          Objectives:

          The purpose of our study was to compare using oral midazolam in contrast to prescribing no sedative medication for voiding dysfunction in children undergoing VCUG.

          Patients and Methods:

          In a clinical trial, we studied 84 children referred for VCUG. Children were allocated randomly into two equal groups. The intervention group received 0.5 mg/kg midazolam orally half an hour before the VCUG procedure. Then both groups were compared using statistical methods.

          Results:

          Then both groups were compared using statistical methods. In more than half of the patients, the main cause of performing VCUG was urinary tract infection. Dysuria was evaluated immediately after VCUG and was more frequent in girls than in boys (P = 0.006). After one week, the urinary irritation and restlessness in the intervention group was significantly lower than the control group.

          Conclusion:

          The use of midazolam 0.5 mg/kg reduced children's stress and increased their cooperation during the procedure.

          Related collections

          Most cited references11

          • Record: found
          • Abstract: found
          • Article: not found

          Pharmacokinetics of midazolam in children: comparative study of intranasal and intravenous administration.

          Twelve children 1-5 y old were randomly assigned to receive midazolam 0.2 mg.kg-1 either by the intravenous (IV) or intranasal (IN) routes. After IN administration the rapid onset of absorption was observed (tmax 12 min). After both routes of administration the half-life was similar (2.2 h IN and 2.4 h IV). After IN administration the apparent plasma clearance and volume of distribution were about twice as high as after IV administration. The results are consistent with an estimated mean bioavailability of 55%.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study.

            Sedation with midazolam facilitates the performance of diagnostic procedures in children, including voiding cystourethrography (VCUG). However, the influence of sedation on voiding and imaging results have not been adequately evaluated. Midazolam and placebo were compared to assess discomfort during VCUG and to evaluate if sedation influenced the outcome of the examination. The study was prospective, randomised and double-blind, and included 95 children, 48 in the midazolam group (median age 2.2 years) and 47 in the placebo group (median age 3.2 years). The evaluation included the child's/parent's experience of the VCUG, as well as the examination results. The children/parents in the midazolam group experienced the VCUG as less distressing compared to those in the placebo group ( P<0.001). Forty-six of 48 children sedated with midazolam could void during the imaging procedure compared to 38 of 47 children given placebo ( NS). There was no difference in frequency or grade of vesicoureteric reflux or bladder emptying between the groups. When sedation is required to perform VCUG in children, midazolam can be used without negative effect on the outcome of the examination.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Conscious sedation reduces distress in children undergoing voiding cystourethrography and does not interfere with the diagnosis of vesicoureteric reflux: a randomized controlled study.

              Voiding cystourethrography (VCU) is a distressing procedure for children. Conscious sedation using oral midazolam may reduce this distress, but its use may also alter the ability of the VCU to show vesicoureteric reflux (VUR). The objectives of our study were to assess the effectiveness of conscious sedation using oral midazolam when administered routinely in children undergoing VCU and to ensure that conscious sedation using oral midazolam does not alter the ability of VCU to show VUR. Our study was a randomized double-blind controlled trial performed at a university teaching hospital; our study group consisted of children over the age of 1 year who been referred for their first VCU examination from July 2001 to July 2003. Participants were randomized to receive a placebo or midazolam syrup (0.5 mg/kg) before the examination. The primary outcome measures were the Groningen Distress Rating Scale (GDRS) and grading of VUR, as defined by the international grading system established by the International Reflux Study Group. There were no serious adverse events. One hundred thirty-nine children were randomized in the study, and 117 underwent complete assessment. Eight who underwent VCU after the study day were included in a "complete case" intention-to-treat analysis. In the placebo group, 34 children (61%) experienced serious distress or severe distress (GDRS score, 3 or 4). In the midazolam group, 16 children (26%) experienced the same degree of distress. There was a significant difference between the GDRS scores (nonlinear mixed-model analysis, p < 0.001) of the two study groups. The number needed to treat to reduce serious or severe distress in one child was 2.9 (95% CI, 1.9-5.5). VUR was identified in 16% of all children. There was no difference in VUR grading between the groups (nonlinear mixed-model analysis, p = 0.31). Routine use of oral midazolam (0.5 mg/kg) for conscious sedation of children undergoing VCU reduces distress and does not alter the ability of VCU to show VUR well enough to allow diagnosis.
                Bookmark

                Author and article information

                Journal
                Nephrourol Mon
                Nephrourol Mon
                10.5812/numonthly
                Kowsar
                Nephro-urology Monthly
                Kowsar
                2251-7006
                2251-7014
                01 May 2014
                May 2014
                : 6
                : 3
                : e17168
                Affiliations
                [1 ]Department of Pediatric, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
                [2 ]Department of Radiology, Mashhad University of Medical Sciences, Mashhad, IR Iran
                [3 ]Department of Pediatric, Vaseei Hospital, Sabzevar University of Medical Sciences, Sabzevar, IR Iran
                [4 ]Department of Social Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
                [5 ]Education Development Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
                Author notes
                [* ]Corresponding author: Yalda Ravanshad, Education Development Center, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel/Fax: +98-5118713640, E-mail: ravanshady@ 123456mums.ac.ir
                Article
                10.5812/numonthly.17168
                4090665
                298fa1cb-8f0f-4ea8-add0-091fc6f2ee30
                Copyright © 2014, Nephrology and Urology Research Center; Published by Kowsar Corp.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 December 2013
                : 04 March 2014
                Categories
                Research Article

                midazolam,voiding cystourethrography,child
                midazolam, voiding cystourethrography, child

                Comments

                Comment on this article