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

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 (0.2mg/kg) to all children requiring K-wire removal in the outpatient department.