Midazolam sedation in children

Our preferred policy for sedation in children is to use intramuscular ketamine - details here

If using midazolam

The oral route leads to onset of effect in 30 - 45 minutes. Because the injectable preparation is used, and tastes horrible, you should flavour it or mix to 1 mg/ml with simple elixir. Absorption / metabolism can also be variable

Weight Nasally Orally

      0.2 mg/kg nasally  or 0.5 mg/kg orally * (18 months - 8 years)
15kg 3 mg 7.5 mg  
  • Contraindications
    • Benzodiazepine sensitivity
    • Caution if coadministered with opiates ..reduce the dose
    • Erythromycin, cimetidine and some antifungals can lead to profound sedation

     

  • The nasal route leads to more rapid onset of effect (7-10 minutes)
    • It cannot be used in children with an URTI and its absorption can be quite variable

     

  • Prinicpal side effects are
    • Cardiorespiratory depression
    • Paradoxical excitement and emergence phenomena
20kg 4 mg 10 mg
25kg 5 mg 12.5 mg
30kg 6 mg 15 mg
35kg 7 mg  
40kg 9 mg  
50kg 10 mg  
60kg 12 mg  

Drafted by Dr Íomhar O' Sullivan and Dr Ian Higginson 01/08/03,  Next review date 01/08/2005