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Sedation with intranasal midazolam of Angolan children undergoing invasive procedures
Author(s) -
Kawanda Lumana,
Capobianco Ivan,
Starc Meta,
Felipe Daniel,
Za Davide,
Barbi Egidio,
Munkela Nadine,
Rodrigues Verónica,
Malundo Lúis,
Not Tarcisio
Publication year - 2012
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2012.02691.x
Subject(s) - medicine , midazolam , crying , sedation , ambulatory , anesthesia , surgery , psychiatry
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.