Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed Tomography
Introduction:Â 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...
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2018-12-01
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| Series: | Archives of Academic Emergency Medicine |
| Subjects: | |
| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/279 |
| _version_ | 1818505798164152320 |
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| author | Hassan Barzegari Behzad Zohrevandi Kambiz Masoumi Arash Forouzan Ali Asgari Darian Shaqayeq Khosravi |
| author_facet | Hassan Barzegari Behzad Zohrevandi Kambiz Masoumi Arash Forouzan Ali Asgari Darian Shaqayeq Khosravi |
| author_sort | Hassan Barzegari |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T21:55:47Z |
| format | Article |
| id | doaj.art-b1bd9fc264a74408922e4e4decf84780 |
| institution | Directory Open Access Journal |
| issn | 2645-4904 |
| language | English |
| last_indexed | 2024-12-10T21:55:47Z |
| publishDate | 2018-12-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj.art-b1bd9fc264a74408922e4e4decf847802022-12-22T01:32:03ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042018-12-013310.22037/aaem.v3i3.279Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed TomographyHassan Barzegari0Behzad Zohrevandi1Kambiz Masoumi2Arash Forouzan3Ali Asgari Darian4Shaqayeq Khosravi5Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.Department of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Emergency Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranIntroduction: 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.https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/279Promethazinemidazolamanti-anxiety agentsconscious sedation |
| spellingShingle | Hassan Barzegari Behzad Zohrevandi Kambiz Masoumi Arash Forouzan Ali Asgari Darian Shaqayeq Khosravi Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed Tomography Archives of Academic Emergency Medicine Promethazine midazolam anti-anxiety agents conscious sedation |
| title | Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed Tomography |
| title_full | Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed Tomography |
| title_fullStr | Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed Tomography |
| title_full_unstemmed | Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed Tomography |
| title_short | Comparison of Oral Midazolam and Promethazine with Oral Midazolam alone for Sedating Children during Computed Tomography |
| title_sort | comparison of oral midazolam and promethazine with oral midazolam alone for sedating children during computed tomography |
| topic | Promethazine midazolam anti-anxiety agents conscious sedation |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/279 |
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