Oral diphenhydramine-midazolam versus oral diphenhydramine for pediatric sedation in the emergency department

Abstract

Background: Sedation is defined as the attenuation of CNS reflexes following usage of some medications; this can be used to provide patient comfort with no undesirable loss of consciousness. Objectives: This study focused on the efficacy of oral diphenhydramine-midazolam versus oral diphenhydramine for pediatric sedation in the emergency department. Patients and Methods: One hundred children up to 13 years, referred to the emergency department for suturing their wounds, were randomized into two groups. Group I received 1.25 mg/kg diphenhydramine and group II received 1.25 mg/kg diphenhydramine plus 0.5 mg/kg midazolam, orally. Later, the drug compliance and anxiety were categorized. Child behavior patterns such as crying, consciousness and movement were recorded. Two weeks after discharge, subjects were followed-up for any experience of complication. Results: The maximum time to achieve the optimal sedation was 16.13 ط£آ¯?ط¢آ½ 4.78 minutes in group I and 7.1 ط£آ¯?ط¢آ½ 2.49 minutes in group II (P < 0.0001). Behavior study of the children was obtained by phone calls to their parents 2 weeks after discharge; restlessness and insomnia were less frequently seen in group II in comparison with group I (P < 0.0001) Conclusions: Combination of diphenhydramine-midazolam in comparison with only diphenhydramine, provides a higher quality of sedation, with fewer complications before diagnostic and therapeutic procedures in children.