Primary Article

Conscious Sedation With High-Dose Midazolam for Pediatric Gastrointestinal Endoscopy

Authors: DAVID A. GREMSE MD, SUJATA KUMAR MD, ALAN I. SACKS MD

Abstract

ABSTRACT Background.Midazolam is used frequently to sedate children for gastrointestinal endoscopy. The sedative dosage of intravenous midazolam commonly reported in children is up to 0.3 mg/kg. We hypothesized that larger doses of midazolam could be used for pediatric endoscopy. Methods.We retrospectively reviewed the medical records of 116 pediatric patients (aged 1 year to 18 years) who had endoscopy. The efficacy and side effects of sedation in 45 patients who received midazolam doses of ≥0.3 mg/kg were compared with the same effects in 71 children who received <0.3 mg/kg. Results.All patients received = 1 mg/kg meperidine (up to 50 mg) intravenously. The blood pressure, pulse rate, respiratory rate, oxygen saturation, degree and duration of sedation, and incidence of side effects such as hypotension, hypoxia, or vomiting were similar in both groups. Conclusions.Intravenous doses of midazolam >0.3 mg/kg can be used for conscious sedation in children.

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