Oral midazolam for removal of Kirschner wires in the children's orthopaedic outpatient department: a randomized controlled trial

J Pediatr Orthop. 2010 Mar;30(2):130-4. doi: 10.1097/BPO.0b013e3181ced3ae.

Abstract

Background: Use of Kirschner wires (K-wires) is common in pediatric elbow fracture treatment. We investigate whether anxiety levels at removal of wires may be reduced using oral midazolam.

Methods: This was a prospective randomized controlled trial with 2 groups, with midazolam and with placebo.

Results: Forty-two children with an average age of 7.1 years (range, 3.6-12.3 y) had complete documentation for analysis. The change in anxiety scores was not significantly different between the 2 groups. Forty-five percent of children in the midazolam group had reduced anxiety levels compared with 18% of children given placebo, but this difference was not significant (P=0.102). The anxiety scores before and after wire removal in the midazolam group were not significantly different from the placebo group scores.

Conclusions: We do not recommend the routine administration of midazolam (0.2 mg/kg) to all children requiring K-wire removal in the outpatient department.

Level of evidence: I.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adjuvants, Anesthesia
  • Administration, Oral
  • Anti-Anxiety Agents / administration & dosage
  • Anti-Anxiety Agents / therapeutic use*
  • Anxiety / drug therapy*
  • Anxiety / etiology
  • Bone Wires
  • Child
  • Child, Preschool
  • Device Removal / methods*
  • Double-Blind Method
  • Elbow Injuries
  • Elbow Joint / surgery
  • Female
  • Fracture Fixation, Internal / methods
  • Fractures, Bone / surgery
  • Humans
  • Male
  • Midazolam / administration & dosage
  • Midazolam / therapeutic use*
  • Outpatients
  • Prospective Studies
  • Treatment Outcome

Substances

  • Adjuvants, Anesthesia
  • Anti-Anxiety Agents
  • Midazolam