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Pediatric Radiology

, Volume 33, Issue 4, pp 247–249 | Cite as

Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study

  • Eira Stokland
  • Svenerik Andréasson
  • Bo Jacobsson
  • Ulf Jodal
  • Barbro Ljung
Original Article

Abstract

Background

Sedation with midazolam facilitates the performance of diagnostic procedures in children, including voiding cystourethrography (VCUG). However, the influence of sedation on voiding and imaging results have not been adequately evaluated.

Objective

Midazolam and placebo were compared to assess discomfort during VCUG and to evaluate if sedation influenced the outcome of the examination.

Materials and methods

The study was prospective, randomised and double-blind, and included 95 children, 48 in the midazolam group (median age 2.2 years) and 47 in the placebo group (median age 3.2 years). The evaluation included the child's/parent's experience of the VCUG, as well as the examination results.

Results

The children/parents in the midazolam group experienced the VCUG as less distressing compared to those in the placebo group (P<0.001). Forty-six of 48 children sedated with midazolam could void during the imaging procedure compared to 38 of 47 children given placebo (NS). There was no difference in frequency or grade of vesicoureteric reflux or bladder emptying between the groups.

Conclusions

When sedation is required to perform VCUG in children, midazolam can be used without negative effect on the outcome of the examination.

Keywords

Sedation Midazolam Voiding cystourethrography 

Notes

Acknowledgements

Financial support was obtained from the Swedish Medical Research Council and the Frimurare-Barnhusdirektionen.

References

  1. 1.
    Phillips D, Watson AR, Collier J (1996) Distress and radiological investigations of the urinary tract in children. Eur J Pediatr 155:684–687PubMedGoogle Scholar
  2. 2.
    Robinson M, Savage J, Stewart M, et al (1999) The diagnostic value, parental and patient acceptability of micturating cysto-urethrography in children. Ir Med J 92:366–368PubMedGoogle Scholar
  3. 3.
    Lebowitz RL, Olbing H, Parkkulainen. KV, et al (1985) International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 15:105–109PubMedGoogle Scholar
  4. 4.
    Ljung, B, Andreasson S (1996) Comparison of midazolam nasal spray to nasal drops for the sedation of children. Nucl Med Technol 24:32–34Google Scholar
  5. 5.
    Ljungman G, Kreuger A, Andréasson S, et al (2000) Midazolam nasal spray reduces procedural anxiety in children. Pediatrics 105:73–78PubMedGoogle Scholar
  6. 6.
    Bozkurt P, Kilic N, Kaya G, et al (1996) The effects of intranasal midazolam on urodynamic studies in children. Br J Urol 78:282–286PubMedGoogle Scholar
  7. 7.
    Katz J, MeIzak R (1999) Measurement of pain. Surg Clin N Am 79:231–52PubMedGoogle Scholar
  8. 8.
    Bradely JW (1968) Distribution-free statistical tests. Prentice Hall, London, pp 68–86Google Scholar
  9. 9.
    Odén A, Wedel H (1975) Arguments for Fischer's permutation test. Ann Stat 13:518–520Google Scholar
  10. 10.
    Maxwell, AE (1961) Analyzing qualitative data. Methuen, London, pp 63–72Google Scholar
  11. 11.
    Elder JS, Longenecker R (1995) Premedication with oral midazolam for voiding cystourethrography in children: safety and efficacy. AJR 164:1229–1234Google Scholar
  12. 12.
    Schmit P, Sfez M (1997) Management of anxious and painful manifestations in pediatric uroradiology. J Radiol 78:367–372PubMedGoogle Scholar
  13. 13.
    Ha JH, Lee KY, Kim WJ (1993) The action of diazepam in the isolated rat detrusor muscle. J Urol 150:229–234PubMedGoogle Scholar
  14. 14.
    Phillips DA, Watson AR, MacKinlay D (1998) Distress and the micturating cystourethrogram: does preparation help? Acta Paediatr 87:175–179PubMedGoogle Scholar
  15. 15.
    Edwinson M, Lindahl S (1986) Preparation of children for urinary X-rays and the use of premedication. World Pediatr Child Care 1:183–186Google Scholar
  16. 16.
    Stephens BK, Barkey ME, Hall HR (1999) Techniques to comfort children during stressful procedures. Accid Emerg Nurs 7:226–236PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Eira Stokland
    • 1
  • Svenerik Andréasson
    • 2
  • Bo Jacobsson
    • 1
  • Ulf Jodal
    • 3
  • Barbro Ljung
    • 1
  1. 1.Department of Paediatric Radiology and Clinical PhysiologyThe Queen Silvia Children's Hospital
  2. 2.Department of Paediatric AnaesthesiologyThe Queen Silvia Children's Hospital
  3. 3.Department of PaediatricsThe Queen Silvia Children's Hospital

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