Eisapour Ali, Mehrayin Raheleh, Esmaeili-Dooki Mohammadreza
Non-Communicable pediatric diseases research center, Babol University of medical science, Babol, Iran.
Med Arch. 2015 Oct;69(5):289-92. doi: 10.5455/medarh.2015.69.289-292. Epub 2015 Oct 4.
The use of sedative medications may be effective in the success and facilitation of the intussusception non-surgical treatment. Therefore, the purpose of this study was to examine the effect of midazolam on decreasing the duration of intussusception hydrostatic reduction in children.
In a double-blind clinical trial, 32 children were diagnosed with ileocolic intussusception based on sonographic findings, were studied and randomly divided into two groups. After obtaining written informed consent from the parents, 5 minutes before reduction, an intravenous Midazolam at the concentration of 1.0 mg/kg (up to 3 mg) was infused, and then barium reduction was performed under fluoroscopy guideline. In the control group, sterile water was injected as placebo and the remaining reduction steps were performed compared with the experiment group.
Of 16 patients that received Midazolam, 15 patients demonstrated successful reduction; and of 16 patients that received distilled water, only 11 patients showed successful reduction (P=0.07). The mean duration of a successful reduction in the Midazolam group and placebo was 34.8±11.35 and 32.73±19.2 min, respectively (P=0.733).
The use of Midazolam as a benzodiazepine with known sedative and muscle relaxant effects can increase the success rate of enema reduction in intussusception.
使用镇静药物可能有助于肠套叠非手术治疗的成功实施。因此,本研究旨在探讨咪达唑仑对缩短儿童肠套叠水压复位持续时间的效果。
在一项双盲临床试验中,32名根据超声检查结果诊断为回结肠型肠套叠的儿童接受了研究,并随机分为两组。在获得家长书面知情同意后,复位前5分钟,静脉注射浓度为1.0mg/kg(最大剂量3mg)的咪达唑仑,然后在荧光透视引导下进行钡剂复位。对照组注射无菌水作为安慰剂,其余复位步骤与试验组相同。
接受咪达唑仑的16例患者中,15例复位成功;接受蒸馏水的16例患者中,只有11例复位成功(P=0.07)。咪达唑仑组和安慰剂组成功复位的平均持续时间分别为34.8±11.35分钟和32.73±19.2分钟(P=0.733)。
使用具有已知镇静和肌肉松弛作用的苯二氮䓬类药物咪达唑仑可提高肠套叠灌肠复位的成功率。