Evaluation of Intranasal Midazolam for Pediatric Sedation during the Suturing of Traumatic Lacerations: A Systematic Review.

Autor:	Gómez-Manzano FJ; Facultad de Fisioterapia y Enfermería, Universidad de Castilla La Mancha, 45071 Toledo, Spain.; Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain.; IES Juanelo Turriano, Consejería de Educación, Cultura y Deportes de Castilla-La Mancha, 45007 Toledo, Spain., Laredo-Aguilera JA; Facultad de Fisioterapia y Enfermería, Universidad de Castilla La Mancha, 45071 Toledo, Spain.; Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain., Cobo-Cuenca AI; Facultad de Fisioterapia y Enfermería, Universidad de Castilla La Mancha, 45071 Toledo, Spain.; Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain., Rabanales-Sotos J; Facultad de Enfermería, Universidad de Castilla-La Mancha, 02071 Albacete, Spain., Rodríguez-Cañamero S; Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain.; Hospital Universitario de Toledo, Servicio de Salud de Castilla-La Mancha, 45007 Toledo, Spain., Martín-Espinosa N; Facultad de Fisioterapia y Enfermería, Universidad de Castilla La Mancha, 45071 Toledo, Spain., Carmona-Torres JM; Facultad de Fisioterapia y Enfermería, Universidad de Castilla La Mancha, 45071 Toledo, Spain.; Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain.
Jazyk:	angličtina
Zdroj:	Children (Basel, Switzerland) [Children (Basel)] 2022 Apr 29; Vol. 9 (5). Date of Electronic Publication: 2022 Apr 29.
DOI:	10.3390/children9050644
Abstrakt:	Objective: The objective of this study was to evaluate the efficacy and safety of intranasal midazolam as part of a paediatric sedation and analgesic procedure during the suturing of traumatic lacerations in paediatric emergency departments. Methodology: A systematic review of clinical trials was completed in July 2021. The databases consulted were PUBMED, SCOPUS, WEB OF SCIENCE, NICE and Virtual Health Library. Eligibility Criteria: randomised and nonrandomised clinical trials. Two independent, blinded reviewers performed the selection and data extraction. The participants were 746 children, of whom, 377 received intranasal midazolam. All of the children were admitted to an emergency department for traumatic lacerations that required suturing. The quality of the articles was evaluated with the Jadad scale. This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Nine studies were included in the review. The intranasal administration of midazolam in healthy children produces anxiolysis and minimal/moderate sedation without serious side effects. Although there are combinations of parenteral drugs that produce deeper sedation, they also have greater adverse effects. No significant differences in the initiation of sedation and the suture procedure were found between the intranasal route and the parenteral route. Conclusions: The use of intranasal midazolam in healthy children produces sufficiently intense and long-lasting sedation to allow for the suturing of traumatic lacerations that do not present other complications; therefore, this drug can be used effectively in paediatric emergency departments.
Databáze:	MEDLINE
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