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NASAL SEDATIVE MAKES SUTURING LESS STRESSFUL FOR CHILDREN.

Anxiety heightens the trauma of suturing even simple wounds in small children. Intranasal midazolam, a short- acting benzodiazepine with a rapid onset, may fit the bill as a stress reducer.

Emergency-department physicians randomized 59 preschoolers with simple lacerations to receive 0.4 mg/kg of midazolam (Versed) intranasally, a saline placebo intranasally, or no treatment. All children then received local lidocaine injections. The two control groups had similar responses, and their results were pooled. Compared with controls, the 27 children given midazolam cried and struggled significantly less, and had less physiologic evidence of anxiety and pain: their heart rates and blood pressures were significantly lower. Two-thirds of parents in the midazolam group felt the drug was beneficial, compared with only one third of control parents. The only adverse effect reported for midazolam was temporary unsteady gait in two toddlers. No apnea or desaturation occurred.

Anyone involved in suturing young children will testify that reducing the anxiety surrounding this procedure is a major achievement. Let's hope that this method pans out.

— RAD

Published in Journal Watch General Medicine March 12, 1993

Citation(s):

Theroux MC et al. Efficacy of intranasal midazolam in facilitating suturing of lacerations in preschool children in the emergency department. Pediatrics 1993 Mar 91 624-627.

• Medline abstract (Free)