Midazolam Versus Fentanyl as Premedication for Painful Procedures in Children with Cancer
1992
Premedication for painful procedures in children with cancer is not
routinely used. Many medications used are only intermittently effective or
require special equipment or anesthesia support. In a randomized,
double-blind, crossover study, the safety and efficacy of midazolam, a
short-acting benzodiazepine, were compared with the safety and efficacy of
fentanyl, a short-acting narcotic analgesic. In 25 children studied, 100% of
children and their parents preferred study drugs to any previous
premedication. Seventy-two percent preferred midazolam to fentanyl.
Preprocedural anxiety, adverse behavioral symptoms, and visual analog scales
all improved and side effects were minimal. It is concluded that premedication
for painful procedures should be used routinely in children with cancer. With
proper monitoring, fentanyl and midazolam can be used safely in the outpatient
clinic setting. Midazolam was found to be the drug of preference for the
majority of patients.
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