Evaluation of intranasal midazolam in refraction and fundus examination of young children with strabismus

• Published in: Journal of pediatric ophthalmology and strabismus Vol. 42; no. 6; pp. 355 - 359
• Main Authors: Altintas, Ozgül, Karabas, V Levent, Demirci, Göktug, Onur, Inci, Caglar, Yusuf
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01.11.2005
• Subjects: Administration, Intranasal; Anesthesia; Anti-Anxiety Agents - administration & dosage; Autism; Brain cancer; Cataracts; Cerebral palsy; Children & youth; Conscious Sedation - methods; Diagnostic Techniques, Ophthalmological; Drug dosages; Female; Fundus Oculi; Glaucoma; Humans; Infant; Male; Metabolism; Midazolam - administration & dosage; Parents & parenting; Pediatrics; Prospective Studies; Refraction, Ocular; Strabismus - diagnosis; Transplants & implants
• ISSN: 0191-3913; 1938-2405
• DOI: 10.3928/01913913-20051101-04

To determine the clinical sedative effect and dosage of intranasal midazolam in refraction and fundus examination of children with strabismus. Refraction and fundus examination with (n = 28) and without (n = 24) sedation were performed in 52 children with strabismus whose ages ranged from 7 to 26 months. We delivered a 5-mg/mL solution of midazolam via a syringe for 60 seconds to provide a dose of 0.2 mg/kg. We repeated the dose to a maximum of 0.3 mg/kg if there was no clinical sedative response after 10 to 15 minutes. The ease of examination and sedation for each patient was scored by a blinded observer. The groups were evaluated for ease of examination and the time needed to complete it. We obtained clinically adequate sedation at a mean (+/- standard deviation) of 15 minutes (+/- 2.69 minutes). Sedation was achieved with a mean dose of 2.64 mg/kg (+/- 0.66 mg/kg). Children receiving midazolam had significantly calmer examination scores. The time needed to complete the examination was statistically significantly shorter for these children than for children not receiving sedation (P < .05). Intranasal midazolam is a beneficial drug and method of delivery for the sedation of anxious children with strabismus undergoing refraction and fundus examination. Sedation prior to examination is effective in reducing the anxiety and time associated with ophthalmologic examination of children with strabismus.