TY - JOUR T1 - Sedation with intranasal midazolam of Angolan children undergoing invasive procedures. JF - Acta Paediatr Y1 - 2012 A1 - Kawanda, Lumana A1 - Capobianco, Ivan A1 - Starc, Meta A1 - Felipe, Daniel A1 - Zanon, Davide A1 - Barbi, Egidio A1 - Munkela, Nadine A1 - Rodrigues, Verónica A1 - Malundo, Lúis A1 - Not, Tarcisio KW - Administration, Intranasal KW - Adolescent KW - Ambulatory Surgical Procedures KW - Angola KW - Child KW - Child Behavior KW - Child, Preschool KW - Conscious Sedation KW - Crying KW - Female KW - Humans KW - Hypnotics and Sedatives KW - Infant KW - Male KW - Midazolam KW - Prospective Studies AB -

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'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's reactivity score, we gave a score to four different types of children'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's job easier.

VL - 101 IS - 7 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22458936?dopt=Abstract ER -