• Arch Iran Med · Nov 2014

    Randomized Controlled Trial

    Melatonin and intravenous midazolam administered orally in drug induced sleep electroencephalography of children: randomized clinical trial of efficacy.

    • Razieh Fallah, Yaser Yadegari, Shekofah Behdad, and Akhavan KarbasiSedighahSDepartment of Pediatrics, Children Growth Disorders Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran..
    • Department of Pediatrics, Children Growth Disorders Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. sakarbasi@yahoo.com.
    • Arch Iran Med. 2014 Nov 1; 17 (11): 741-5.

    BackgroundElectroencephalography (EEG) is a useful diagnostic tool in the diagnosis of seizure and differentiating it from seizure-like attacks. Cooperation and immobility of the patient is crucial and in children who do not naturally sleep, pharmacological agents and procedural sedation should be used for sleep inducement. The purpose of this study was to compare efficacy and safety of melatonin and intravenous solution of midazolam administered orally in sedation induction for EEG of children.MethodsIn a parallel single-blinded randomized clinical trial, sixty 1 - 8 year old children who were referred to EEG Unit of Shahid Sadoughi Hospital, Yazd, Iran from September 2011 to March 2012 were evaluated. The Children were randomly assigned into two groups to receive orally 0.3 mg/kg melatonin or 0.75 mg/kg ampoule of midazolam. The primary outcome was efficacy in adequate sedation (Ramsay sedation score of four) and recording of EEG. Secondary outcome was clinical side effects.ResultsNineteen girls (31.7%) and 41 boys (68.3%) with the mean age of 2.8 ± 1.8 years were evaluated. Adequate  sedation  and  recording  of EEG was  achieved in  36.7% of  midazolam  group and  in 73.3%  of  melatonin group, (p = 0.004). Transient agitation was seen in 6.6% of midazolam group. No significant difference was observed from the viewpoint of side effects frequency between the two drugs, (p = 0.15).Conculsion  Melatonin is a safe and an effective drug in sedation induction for EEG in children.

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