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In a randomized controlled trial, investigators compared the effectiveness of oral midazolam (0.5 mg/kg; maximum dose, 15 mg) and aerosolized buccal and intranasal midazolam (0.3 mg/kg; maximum dose, 10 mg) for reducing distress in 180 children (age range, 6 months to 7 years) who underwent simple laceration repair at a Seattle emergency department during a 3-year period. Two nurses who were blinded to treatment group viewed video recordings of the procedures and rated distress every 5 minutes using the Children's Hospital of Eastern Ontario Pain Scale and a 5-point sedation scale.
Significantly more patients in the intranasal group than in the other two groups achieved the optimal sedation score (75% vs. approximately 60%). The proportion o…