From: Midazolam for sedation before procedures in adults and children: a systematic review update
Patient or population: Children requiring sedation before procedures that require motion control, including echocardiography, lumbar puncture, micturating cystourethrograms, and neuroimaging Settings: Paediatric ICU in USA, emergency departments in USA and Iran and Medical Imaging department in Turkey Intervention: Oral midazolam Comparison: Oral chloral hydrate | ||||||
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Outcomes | Illustrative comparative risksa (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
Assumed risk | Corresponding risk | |||||
Chloral hydrate | Oral midazolam | |||||
Level of sedation on sedation assessment scale Derakhshanfar 2013 reported the number of patients reaching moderate sedation on Wheeler’s sedation scale and Salehi 2017 reported the number of patients reaching moderate sedation on the RASS scale. | 596 per 1000 | 179 per 1000 (66 to 489) | RR 0.3 (0.11 to 0.82) | 228 (2) | Very low1 ⊕⊝⊝⊝ | |
Numeric rating of anxiety or number of participants rated as anxious (numerical rating scale of 1–5 with lower scores indicating less anxiety) | 2.5 | MD was 0.77 lower2 (2.2 lower to 0.68 higher) | 88 (2) | Low3 ⊕⊕⊝⊝ | The assumed and corresponding risks were estimated from the SMD, which was − 0.26 (95% CI − 0.75 to 0.23). | |
Proportion of incomplete procedures or where there was difficulty performing the procedures | 56 per 1000 | 226 per 1000 (108 to 474) | RR 4.01 (1.92 to 8.4) | 268 (4) | Moderate4 ⊕⊕⊕⊝ | |
Discomfort/pain (as defined/measured by the authors of the trial) | No studies reported on this outcome. |