Skip to main content
Top
Published in: Pediatric Radiology 4/2003

01-04-2003 | Original Article

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

Authors: Eira Stokland, Svenerik Andréasson, Bo Jacobsson, Ulf Jodal, Barbro Ljung

Published in: Pediatric Radiology | Issue 4/2003

Login to get access

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.
Literature
1.
go back to reference Phillips D, Watson AR, Collier J (1996) Distress and radiological investigations of the urinary tract in children. Eur J Pediatr 155:684–687PubMed Phillips D, Watson AR, Collier J (1996) Distress and radiological investigations of the urinary tract in children. Eur J Pediatr 155:684–687PubMed
2.
go back to reference 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 92:366–368PubMed 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 92:366–368PubMed
3.
go back to reference Lebowitz RL, Olbing H, Parkkulainen. KV, et al (1985) International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 15:105–109PubMed Lebowitz RL, Olbing H, Parkkulainen. KV, et al (1985) International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 15:105–109PubMed
4.
go back to reference Ljung, B, Andreasson S (1996) Comparison of midazolam nasal spray to nasal drops for the sedation of children. Nucl Med Technol 24:32–34 Ljung, B, Andreasson S (1996) Comparison of midazolam nasal spray to nasal drops for the sedation of children. Nucl Med Technol 24:32–34
5.
go back to reference Ljungman G, Kreuger A, Andréasson S, et al (2000) Midazolam nasal spray reduces procedural anxiety in children. Pediatrics 105:73–78PubMed Ljungman G, Kreuger A, Andréasson S, et al (2000) Midazolam nasal spray reduces procedural anxiety in children. Pediatrics 105:73–78PubMed
6.
go back to reference Bozkurt P, Kilic N, Kaya G, et al (1996) The effects of intranasal midazolam on urodynamic studies in children. Br J Urol 78:282–286PubMed Bozkurt P, Kilic N, Kaya G, et al (1996) The effects of intranasal midazolam on urodynamic studies in children. Br J Urol 78:282–286PubMed
7.
go back to reference Katz J, MeIzak R (1999) Measurement of pain. Surg Clin N Am 79:231–52PubMed Katz J, MeIzak R (1999) Measurement of pain. Surg Clin N Am 79:231–52PubMed
8.
go back to reference Bradely JW (1968) Distribution-free statistical tests. Prentice Hall, London, pp 68–86 Bradely JW (1968) Distribution-free statistical tests. Prentice Hall, London, pp 68–86
9.
go back to reference Odén A, Wedel H (1975) Arguments for Fischer's permutation test. Ann Stat 13:518–520 Odén A, Wedel H (1975) Arguments for Fischer's permutation test. Ann Stat 13:518–520
10.
go back to reference Maxwell, AE (1961) Analyzing qualitative data. Methuen, London, pp 63–72 Maxwell, AE (1961) Analyzing qualitative data. Methuen, London, pp 63–72
11.
go back to reference Elder JS, Longenecker R (1995) Premedication with oral midazolam for voiding cystourethrography in children: safety and efficacy. AJR 164:1229–1234 Elder JS, Longenecker R (1995) Premedication with oral midazolam for voiding cystourethrography in children: safety and efficacy. AJR 164:1229–1234
12.
go back to reference Schmit P, Sfez M (1997) Management of anxious and painful manifestations in pediatric uroradiology. J Radiol 78:367–372PubMed Schmit P, Sfez M (1997) Management of anxious and painful manifestations in pediatric uroradiology. J Radiol 78:367–372PubMed
13.
go back to reference Ha JH, Lee KY, Kim WJ (1993) The action of diazepam in the isolated rat detrusor muscle. J Urol 150:229–234PubMed Ha JH, Lee KY, Kim WJ (1993) The action of diazepam in the isolated rat detrusor muscle. J Urol 150:229–234PubMed
14.
go back to reference Phillips DA, Watson AR, MacKinlay D (1998) Distress and the micturating cystourethrogram: does preparation help? Acta Paediatr 87:175–179PubMed Phillips DA, Watson AR, MacKinlay D (1998) Distress and the micturating cystourethrogram: does preparation help? Acta Paediatr 87:175–179PubMed
15.
go back to reference Edwinson M, Lindahl S (1986) Preparation of children for urinary X-rays and the use of premedication. World Pediatr Child Care 1:183–186 Edwinson M, Lindahl S (1986) Preparation of children for urinary X-rays and the use of premedication. World Pediatr Child Care 1:183–186
16.
go back to reference Stephens BK, Barkey ME, Hall HR (1999) Techniques to comfort children during stressful procedures. Accid Emerg Nurs 7:226–236PubMed Stephens BK, Barkey ME, Hall HR (1999) Techniques to comfort children during stressful procedures. Accid Emerg Nurs 7:226–236PubMed
Metadata
Title
Sedation with midazolam for voiding cystourethrography in children: a randomised double-blind study
Authors
Eira Stokland
Svenerik Andréasson
Bo Jacobsson
Ulf Jodal
Barbro Ljung
Publication date
01-04-2003
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 4/2003
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-003-0874-0

Other articles of this Issue 4/2003

Pediatric Radiology 4/2003 Go to the issue