From: Midazolam for sedation before procedures in adults and children: a systematic review update
Patient or population: Children requiring sedation before micturating cystourethrograms, and Kirschner wire removal, and adults undergoing endoscopy Settings: X-ray department in Turkey, orthopaedic outpatient department in UK, and endoscopy suites in USA and Thailand Intervention: Oral midazolam Comparison: Placebo | ||||||
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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 | |||||
Placebo | Midazolam | |||||
Level of sedation on a sedation assessment scale (as defined/measured by the authors of the trial) | No studies reported on this outcome. | |||||
Numeric rating of anxiety or number of participants rated as anxious (as defined/measured by the authors of the trial) | 4.62 (measured on a scale that ranged from 0 to 10 with higher scores representing worse anxiety) | MD was 1.9 lower (3.5 lower to 0.3 lower) | 436(4) | Low1 ⊕⊕⊝⊝ | The assumed and corresponding risks were estimated from the SMD, which was − 1 (95% CI − 1.86 to − 0.16). | |
Proportion of incomplete procedures or where there was difficulty performing the procedures (as defined/measured by the authors of the trial) | 439 (4 studies) | Low1 ⊕⊕⊝⊝ | Relative effect was not able to be conducted because there was only one incomplete procedure in the midazolam group in one of the four trials that reported on this outcome. | |||
Discomfort/pain (as defined/measured by the authors of the trial) Scores ranged from 0 to 10 with higher score indicating more pain | 4.62 | MD was 2 lower (2.5 lower to 1.6 lower) | 99 (1 study) | Moderate1 ⊕⊕⊕⊝ |