Anxiety in Children Undergoing VCUG: Sedation or No Sedation?

Background. Voiding cystourethrograms are distressing for children and parents. Nonpharmacological methods reduce distress. Pharmacological interventions for VCUG focus on sedation as well as analgesia, anxiolysis, and amnesia. Sedation has cost, time, and safety issues. Which agents and route shoul...

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Main Author: David W. Herd
Format: Article
Language:English
Published: Wiley 2008-01-01
Series:Advances in Urology
Online Access:http://dx.doi.org/10.1155/2008/498614
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author David W. Herd
author_facet David W. Herd
author_sort David W. Herd
collection DOAJ
description Background. Voiding cystourethrograms are distressing for children and parents. Nonpharmacological methods reduce distress. Pharmacological interventions for VCUG focus on sedation as well as analgesia, anxiolysis, and amnesia. Sedation has cost, time, and safety issues. Which agents and route should we use? Are we sure that sedation does not influence the ability to diagnose vesicoureteric reflux? Methods. Literature search of Medline, EMBASE, and the Cochrane Database. Review of comparative studies found. Results. Seven comparative studies including two randomised controlled trials were reviewed. Midazolam given orally (0.5-0.6 mg/kg) or intranasally (0.2 mg/kg) is effective with no apparent effect on voiding dynamics. Insufficient evidence to recommend other sedating agents was found. Deeper sedating agents may interfere with voiding dynamics. Conclusion. Midazolam reduces the VCUG distress, causes amnesia, and does not appear to interfere with voiding dynamics. Midazolam combined with simple analgesia is an effective method to reduce distress to children undergoing VCUG.
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spelling doaj-art-21043f6b12294c9a896fb48393a9dcb12025-02-03T01:33:23ZengWileyAdvances in Urology1687-63691687-63772008-01-01200810.1155/2008/498614498614Anxiety in Children Undergoing VCUG: Sedation or No Sedation?David W. Herd0Department of Paediatrics, Starship Children's Hospital, University of Auckland, Private Bag 92024, Auckland, New ZealandBackground. Voiding cystourethrograms are distressing for children and parents. Nonpharmacological methods reduce distress. Pharmacological interventions for VCUG focus on sedation as well as analgesia, anxiolysis, and amnesia. Sedation has cost, time, and safety issues. Which agents and route should we use? Are we sure that sedation does not influence the ability to diagnose vesicoureteric reflux? Methods. Literature search of Medline, EMBASE, and the Cochrane Database. Review of comparative studies found. Results. Seven comparative studies including two randomised controlled trials were reviewed. Midazolam given orally (0.5-0.6 mg/kg) or intranasally (0.2 mg/kg) is effective with no apparent effect on voiding dynamics. Insufficient evidence to recommend other sedating agents was found. Deeper sedating agents may interfere with voiding dynamics. Conclusion. Midazolam reduces the VCUG distress, causes amnesia, and does not appear to interfere with voiding dynamics. Midazolam combined with simple analgesia is an effective method to reduce distress to children undergoing VCUG.http://dx.doi.org/10.1155/2008/498614
spellingShingle David W. Herd
Anxiety in Children Undergoing VCUG: Sedation or No Sedation?
Advances in Urology
title Anxiety in Children Undergoing VCUG: Sedation or No Sedation?
title_full Anxiety in Children Undergoing VCUG: Sedation or No Sedation?
title_fullStr Anxiety in Children Undergoing VCUG: Sedation or No Sedation?
title_full_unstemmed Anxiety in Children Undergoing VCUG: Sedation or No Sedation?
title_short Anxiety in Children Undergoing VCUG: Sedation or No Sedation?
title_sort anxiety in children undergoing vcug sedation or no sedation
url http://dx.doi.org/10.1155/2008/498614
work_keys_str_mv AT davidwherd anxietyinchildrenundergoingvcugsedationornosedation