Intranasal (IN) midazolam is often used for anxiolysis in pediatrics prior to procedures. In this study, 0.2 mg/kg of IN midazolam (up to 6 mg total dose) was given prior to laceration repair in children 2-10 years.
90% of children were at least minimally sedated at the start of the procedure and these children also displayed less anxiety when measured on a standardized anxiety scale.
Children's whose procedure started 10-20 minutes after IN medication compared to 25-35 minutes had significantly lower anxiety.
IN midazolam can be successful as an anxiolytic, but careful attention should be directed at the timing of the procedure.
References
Martin SR, Bauer K, Heyming TW, Zhu J, Lee H, Kain ZN. Incidence and predictors of nonresponse to intranasal midazolam in children undergoing laceration repair. Acad Emerg Med. 2025 Feb 3. doi: 10.1111/acem.15106. Epub ahead of print. PMID: 39901057.
