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In addition to local anesthesia, brief sedation can help minimize children's discomfort during medical procedures such as intravenous (IV) starts and blood draws. In a randomized study, 90 endocrinology patients (age range, 5–18 years; 60 obese, 30 with growth retardation) in Sweden who were undergoing IV starts and had histories of difficult IV access or anxiety about the procedure were randomized to receive 50% inhaled nitrous oxide, 10% nitrous oxide, or oral midazolam (along with placebo — oral plain syrup or oxygen by mask). Patients, parents, and study nurses were blinded to assignments.
Total procedure time, from initial setup to recovery from sedation, was significantly longer (by at least 10 minutes) in the midazolam group than in b…