THE EFFECTS OF INTRANASAL MIDAZOLAM ON URODYNAMIC STUDIES IN CHILDREN

Objective To determine the influence of midazolam on the function of t he lower urinary tract when used to sedate the patient. Patients and m ethods Urodynamic studies were performed on 20 patients (seven boys an d 13 girls, mean age 4.04 years, range 1 day to 10 years) before and a fter the intranasal administration of 0.5 mg/kg of midazolam. The pati ents' heart rate, respiratory rate and oxygen saturation were monitore d and the level of sedation recorded by an anaesthesiologist and a sur geon during the study. Results Heart rate and respiratory rate did not change and the percentage oxygen saturation remained stable throughou t the study period. The childrens' behaviour began to change 3-5 min a fter the intranasal administration of midazolam. The sedation lasted 2 h and the full co-operation of the patient was assured. The differenc e between the initial and post-midazolam evaluation of maximal cystome tric capacity, contractility, compliance, intravesical pressure, maxim um now rate, intravesical pressure at maximum now and the amount of re sidual urine were statistically insignificant (P>0.05). Electromyograp hic characteristics showed no significant change with the use of midaz olam (P>0.05). Conclusion Despite the suggestion that benzodiazepines, especially diazepam, are useful for the relaxation of pelvic floor st riated musculature in voiding dysfunctions, there was no effect on uro dynamic variables when midazolam was used in a single dose intranasall y. The anxiolytic and sedative effects allowed children to undergo uro dynamic studies in comfort.