{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:14:51Z","timestamp":1787314491260,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T00:00:00Z","timestamp":1571011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    One of the most widely used options for minimal\/moderate sedation in pediatric patients is oral midazolam, as it presents an alternative to less well\u2010accepted routes of administration (\n                    <jats:italic>eg,<\/jats:italic>\n                    intravenous or intranasal) of this well\u2010known efficacious and well\u2010tolerated short\u2010acting benzodiazepine. A systematic review of the literature was conducted in order to identify clinical studies evaluating the effectiveness of oral midazolam for sedation in pediatric patients in the context of premedication before anesthesia or during diagnostic\/treatment procedures. The percentage of responders (response rate) after single administration of oral midazolam was evaluated and compared versus placebo in a subset of placebo\u2010controlled studies. The range of oral midazolam doses providing effective sedation in the different pediatric age subsets was analyzed in order to assess optimum dosing strategies. A total of 25 pediatric clinical studies, utilizing a variety of measures of sedation effectiveness, were selected. These studies included a total of 1472 patients (aged 4\u00a0months\u201018\u00a0years) treated with midazolam (0.25\u20101.5\u00a0mg\/kg) and 138 patients treated with placebo. The response rates [95% confidence interval] with oral midazolam ranged from 36.7%\u00a0[21.6%, 54.9%] to 97.8%\u00a0[86.1%, 99.7%], while with placebo response rates ranged from 4.0%\u00a0[0.6%, 23.5%] to 41.0%\u00a0[29.4%, 53.6%]. When considering the 4\u00a0placebo\u2010controlled studies, the odds ratios [95% confidence interval] for the comparison of midazolam vs. placebo ranged from 13.4\u00a0[5.0, 36.0] to 25.9\u00a0[6.7, 100.6]. The analysis of subgroups by context of sedation showed response rates [95% confidence interval] with oral midazolam ranging from 36.7%\u00a0[21.6%, 54.9%] to 97.0%\u00a0[94.8%, 98.3%] for anesthetic premedication and from 56.1%\u00a0[43.1%, 68.4] to 97.8%\u00a0[86.1%, 99.7%] for medical procedures. The efficacy of midazolam for pediatric minimal\/moderate sedation from a dose of 0.25\u00a0mg\/kg and above was demonstrated. The probability of occurrence of adverse events and over\u2010sedation increases with increasing doses.\n                  <\/jats:p>","DOI":"10.1111\/pan.13747","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T03:49:04Z","timestamp":1568951344000},"page":"1094-1106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Efficacy of oral midazolam for minimal and moderate sedation in pediatric patients: A systematic review"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5056-9065","authenticated-orcid":false,"given":"Maria A.","family":"Manso","sequence":"first","affiliation":[{"name":"Clinical Affairs Advicenne, N\u00eemes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Guittet","sequence":"additional","affiliation":[{"name":"Clinical Affairs Advicenne, N\u00eemes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Vandenhende","sequence":"additional","affiliation":[{"name":"Statistics ClinBay Genappe Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u2010Andr\u00e9","family":"Granier","sequence":"additional","affiliation":[{"name":"Clinical Affairs Advicenne, N\u00eemes France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1996.02170370016002"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.03114.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2005.06.004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-2920"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-1212"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000136471.36680.97"},{"issue":"5","key":"e_1_2_6_8_1","first-page":"CD009491","article-title":"Midazolam for sedation before procedures","volume":"2016","author":"Conway A","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_9_1","unstructured":"ModelW.List of Essential Medicines for Children. 5th List. 2015; April 2015 (amended August 2015)."},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.2000.tb05983.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200201000-00006"},{"issue":"4","key":"e_1_2_6_12_1","first-page":"244","article-title":"Validity and reliability of the Observer's Assessment of Alertness\/Sedation scale: study with intravenous midazolam","volume":"10","author":"Chernik DA","year":"1990","journal-title":"J. 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