Sedation during voiding cystourethrography: Comparison of the efficacy and safety of using oral midazolam and continuous flow nitrous oxide

Ilan Keidan, Ruth Zaslansky, Margalith Weinberg, Aviva Ben-Shlush, Jeffrey M. Jacobson, Arie Augarten, Yoram Mor, Jack S. Elder, Christopher Cooper, H. Gil Rushton

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We compare the efficacy and safety profile of oral midazolam and continuous flow 50% nitrous oxide (N2O) for alleviating anxiety and pain during voiding cystourethrography (VCU) in children. Materials and Methods: This prospective, randomized clinical trial study was conducted in the radiology unit of a tertiary care center. Children older than 3 years scheduled for VCU were given either 0.5 mg/kg midazolam orally or continuous flow 50% N2O. Main outcomes were degree of anxiety and pain as assessed by the attending nurse and radiologist performing the test using a behavioral anxiety score, a distress score and an overall satisfaction score, side effects and recovery profile. Results: The study included 47 children (89% girls) with a mean age of 6 years (range 3 to 15). There were 24 subjects in the midazolam group and 23 in the N2O group. Midazolam and N2O provided adequate anxiety and pain relief to perform the examination, yet children given N2O required less restraining and experienced a significantly shorter recovery time (29 ± 10 vs 63 ± 25 minutes, p < 0.001). Conclusions: Continuous flow 50% nitrous oxide and oral midazolam are comparably safe and effective in reducing anxiety and distress during VCU in children older than 3 years. However, N2O provides a more rapid onset of sedating effect and has a shorter recovery time.

Original languageEnglish
Pages (from-to)1598-1601
Number of pages4
JournalJournal of Urology
Volume174
Issue number4 II
DOIs
StatePublished - Oct 2005

Keywords

  • Midazolam
  • Nitrous oxide
  • Sedation

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