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2015 ; 3
(3
): 109-13
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Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for
Sedating Children during Computed Tomography
#MMPMID26495395
Barzegari H
; Zohrevandi B
; Masoumi K
; Forouzan A
; Darian AA
; Khosravi S
Emerg (Tehran)
2015[Sum]; 3
(3
): 109-13
PMID26495395
show ga
INTRODUCTION: Both midazolam and promethazine are recommended to be used as
sedatives in many studies but each have some side effects that limits their use.
Combination therapy as an alternative method, may decreases these limitations.
Therefore, this study aimed to compare midazolam with midazolam-promethazine
regarding induction, maintenance, and recovery characteristics following
pediatric procedural sedation and analgesia. METHODS: Children under 7 years old
who needed sedation for being CT scanned were included in this double-blind
randomized clinical trial. The patients were randomly divided into 2 groups: one
only received midazolam (0.5 mg/kg), while the other group received a combination
of midazolam (0.5 mg/kg) and promethazine (1.25 mg/kg). University of Michigan
Sedation Scale (UMSS) was used to assess sedation induction. In addition to
demographic data, the child's vital signs were evaluated before prescribing the
drugs and after inducing sedation (reaching UMSS level 2). The primary outcomes
in the present study were onset of action after administration and duration of
the drugs' effect. RESULTS: 107 patients were included in the study. Mean onset
of action was 55.4±20.3 minutes for midazolam and 32.5±11.1 minutes for
midazolam-promethazine combination (p<0.001). But duration of effect was not
different between the 2 groups (p=0.36). 8 (7.5%) patients were unresponsive to
the medication, all 8 of which were in the midazolam treated group (p=0.006).
Also in 18 (16.8%) cases a rescue dose was prescribed, 14 (25.9%) were in the
midazolam group and 4 (7.5%) were in the midazolam-promethazine group (p=0.02).
Comparing systolic (p=0.20) and diastolic (p=0.34) blood pressure, heart rate
(p=0.16), respiratory rate (p=0.17) and arterial oxygen saturation level (p=0.91)
showed no significant difference between the 2 groups after intervention.
CONCLUSION: Based on the findings of this study, it seems that using a
combination of midazolam and promethazine not only speeds up the sedation
induction, but also decreases unresponsiveness to the treatment and the need for
a rescue dose.