@article {1887, title = {Sedation with intranasal midazolam of Angolan children undergoing invasive procedures.}, journal = {Acta Paediatr}, volume = {101}, year = {2012}, month = {2012 Jul}, pages = {e296-8}, abstract = {

AIM: Ambulatory surgery is a daily requirement in poor countries, and limited means and insufficient trained staff lead to the lack of attention to the patient{\textquoteright}s pain. Midazolam is a rapid-onset, short-acting benzodiazepine which is used safely to reduce pain in children. We evaluated the practicability of intranasal midazolam sedation in a suburban hospital in Luanda (Angola), during the surgical procedures.

METHODS: Intranasal midazolam solution was administered at a dose of 0.5 mg/kg. Using the Ramsay{\textquoteright}s reactivity score, we gave a score to four different types of children{\textquoteright}s behaviour: moaning, shouting, crying and struggling, and the surgeon evaluated the ease of completing the surgical procedure using scores from 0 (very easy) to 3 (managing with difficulty).

RESULTS: Eighty children (median age, 3 years) were recruited, and 140 surgical procedures were performed. Fifty-two children were treated with midazolam during 85 procedures, and 28 children were not treated during 55 procedures. We found a significant difference between the two groups on the shouting, crying and struggling parameters (p < 0.001). The mean score of the ease of completing the procedures was significantly different among the two groups (p < 0.0001).

CONCLUSION: These results provide a model of procedural sedation in ambulatory surgical procedures in poor countries, thus abolishing pain and making the surgeon{\textquoteright}s job easier.

}, keywords = {Administration, Intranasal, Adolescent, Ambulatory Surgical Procedures, Angola, Child, Child Behavior, Child, Preschool, Conscious Sedation, Crying, Female, Humans, Hypnotics and Sedatives, Infant, Male, Midazolam, Prospective Studies}, issn = {1651-2227}, doi = {10.1111/j.1651-2227.2012.02691.x}, author = {Kawanda, Lumana and Capobianco, Ivan and Starc, Meta and Felipe, Daniel and Zanon, Davide and Barbi, Egidio and Munkela, Nadine and Rodrigues, Ver{\'o}nica and Malundo, L{\'u}is and Not, Tarcisio} }