ABSTRACT
ABSTRACT: Introduction: The objective of this study was to determine the clinical sedative effect and the dosage of intranasal midazolam in fundus and refraction examination of children with strabismus. Materials and Methods: In this prospective study, fundus and refraction examinations with (28) and without (24) sedation were performed in 52 children with strabismus , aged 7 to 26 months of age. We delivered midazolam 5 mg/ml solution by a syringe over a period of 60 seconds to provide a dose of 0.2 mg/kg. We repeated the dose to a maximum of 0.3 mg/kg if there was no clinical sedative response after 10-15 minutes. The ease of examination and sedation were scored by a blind observer in each patient. The groups were evaluated for ease of examination and time needed for completion of examination. Results: We obtained clinically adequate sedation at a mean of 15 2,69 SD minutes. Sedation was achieved with a mean of 2,64 0,66 SD mg/kg. Children receiving midazolam had significantly calmer examination scores. The time needed for completion of examination was statistically significantly shorter than the time needed for children without sedation.(p 0,05) Conclusions: Our study suggests that intranasal midazolam approaches the beneficial drug and method of delivery for the sedation of anxious children with strabismus undergoing refraction and fundus examination. Sedation prior to examination is effective in reducing anxiety and time in ophthalmological examination of children with strabismus.
