Abstract：
Midazolam hydrochloride is a widely accepted benzodiazepine for premedication in pediatric patients. However, there is no consistent conclusion regarding which route of administration is best. We performed a meta-analysis to assess the efficacy and safety of oral versus intranasal midazolam premedication in children.
The PubMed, Embase, Cochrane Library, and Google Scholar databases were searched from inception to June 2022, for randomized controlled trials comparing oral versus intranasal midazolam. Primary outcomes included satisfactory mask acceptance for induction and satisfactory sedation at separation from parents. Secondary outcomes included the incidence of postoperative nausea and vomiting, incidence of nasal irritation, postoperative recovery time, and hemodynamic changes.
Data from 14 studies involving a total of 901 children were obtained. The results indicated that intranasal and oral midazolam premedication in children provided similar satisfactory mask acceptance for induction (RR, 1.02; 95% CI, 0.93-1.13; P=0.64; I2=0%), satisfactory sedation at separation from parents (RR, 0.99; 95% CI, 0.89-1.10; P=0.90; I2=57%), and postoperative recovery time (WMD, -8.01; 95% CI, -20.16-4.14; P=0.20; I2=85%). Additionally, intranasal midazolam premedication was associated with lower incidence of postoperative nausea and vomiting (RR, 0.70; 95% CI, 0.51-0.96; P=0.03; I2=0%) and shorter onset time.
Differences between intranasal and oral midazolam in satisfactory mask acceptance for induction, satisfactory sedation at separation from parents, and postoperative recovery time were not significant. Intranasal midazolam premedication was associated with shorter onset time and higher incidence of nasal irritation.
The PubMed, Embase, Cochrane Library, and Google Scholar databases were searched from inception to June 2022, for randomized controlled trials comparing oral versus intranasal midazolam. Primary outcomes included satisfactory mask acceptance for induction and satisfactory sedation at separation from parents. Secondary outcomes included the incidence of postoperative nausea and vomiting, incidence of nasal irritation, postoperative recovery time, and hemodynamic changes.
Data from 14 studies involving a total of 901 children were obtained. The results indicated that intranasal and oral midazolam premedication in children provided similar satisfactory mask acceptance for induction (RR, 1.02; 95% CI, 0.93-1.13; P=0.64; I2=0%), satisfactory sedation at separation from parents (RR, 0.99; 95% CI, 0.89-1.10; P=0.90; I2=57%), and postoperative recovery time (WMD, -8.01; 95% CI, -20.16-4.14; P=0.20; I2=85%). Additionally, intranasal midazolam premedication was associated with lower incidence of postoperative nausea and vomiting (RR, 0.70; 95% CI, 0.51-0.96; P=0.03; I2=0%) and shorter onset time.
Differences between intranasal and oral midazolam in satisfactory mask acceptance for induction, satisfactory sedation at separation from parents, and postoperative recovery time were not significant. Intranasal midazolam premedication was associated with shorter onset time and higher incidence of nasal irritation.
摘要：
背景：盐酸咪达唑仑是一种广泛接受的苯二氮卓类药物，用于儿科患者的术前用药。然而,关于哪种给药途径最好，尚无一致的结论。我们进行了一项荟萃分析，以评估儿童口服与鼻内咪达唑仑的疗效和安全性。
方法：PubMed，Embase,科克伦图书馆,从开始到2022年6月,我们搜索了GoogleScholar数据库,以比较口服和鼻内咪达唑仑的随机对照试验.主要结果包括满意的诱导面罩接受度和与父母分离时满意的镇静作用。次要结果包括术后恶心和呕吐的发生率，鼻刺激的发生率，术后恢复时间,和血液动力学变化。
结果：获得了14项研究的数据，共涉及901名儿童。结果表明，儿童鼻内和口服咪达唑仑的术前用药提供了类似的满意的面罩接受诱导（RR，1.02；95%CI，0.93-1.13；P=0.64；I2=0%），与父母分离时令人满意的镇静作用(RR，0.99；95%CI，0.89-1.10；P=0.90；I2=57%），和术后恢复时间(WMD，-8.01；95%CI，-20.16-4.14；P=0.20；I2=85%）。此外,鼻内咪达唑仑术前用药与术后恶心和呕吐的发生率较低（RR，0.70；95%CI，0.51-0.96；P=0.03；I2=0%），起效时间较短。
结论：鼻内和口服咪达唑仑在接受满意的诱导面罩方面的差异，与父母分离时令人满意的镇静作用，术后恢复时间差异无统计学意义。鼻内咪达唑仑术前用药与较短的起效时间和较高的鼻腔刺激发生率有关。
方法：PubMed，
结果：获得了14项研究的数据，共涉及901名儿童。
结论：鼻内和口服咪达唑仑在接受满意的诱导面罩方面的差异，
