Intranasal Midazolam Prior to Enema for Management of Constipation in the Pediatric Emergency Department
Abstract
INTRODUCTION: Constipation is a common complaint in the pediatric emergency department (PED). Management often includes an enema administered in the PED, especially for children with significant discomfort or those who have failed outpatient therapy with oral bowel motility agents. Enema administration can be anxiety-provoking and may cause children to further withhold stool. Midazolam, a rapid-acting benzodiazepine, is sometimes given prior to an enema for anxiolysis. This study evaluated the effect of intranasal midazolam on the success rate of bowel movement after an enema for the management of constipation in the pediatric emergency department (PED). METHODS: Retrospective cohort study at a single, academic, quaternary-care hospital. Patients 2 to 10 years of age receiving at least one enema for management of constipation from May 1, 2016, through April 30, 2021, were included. Exclusion criteria include neurodevelopmental disorders, prior abdominal surgeries, or administration of any non-intranasal midazolam anxiolytic agents. The primary outcome was the success of bowel movement in the emergency department (ED). Secondary outcomes included ED length-of-stay (LOS), enema-to-discharge time, number of enemas administered, and admission rates. RESULTS: Intranasal midazolam was administered in 214 (27%) out of 795 encounters. There was no difference in rates of successful bowel movements between the midazolam and no-midazolam groups (83.6% vs. 84.2%, respectively). When…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
Read the paper
Related studies
- Gastrointestinal manifestations in COVID-19
- COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist
- Treatment of norovirus infections: moving antivirals from the bench to the bedside
- Abstracts of the 2012 International Congress of the European Association of Poisons Centres and Clinical Toxicologists, 25 May–1 June 2012, London, UK
- Global Research Trends in Irritable Bowel Syndrome: A Bibliometric and Visualized Study
- Rapid enteric testing to permit targeted antimicrobial therapy, with and without Lactobacillus reuteri probiotics, for paediatric acute diarrhoeal disease in Botswana: A pilot, randomized, factorial, controlled trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.