Sedation level with midazolam: A pediatric surgery approach


. 2022 Jul;30(7):906-917.

doi: 10.1016/j.jsps.2022.05.002.

Epub 2022 May 23.


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Carmen Flores-Pérez et al.

Saudi Pharm J.

2022 Jul.


Midazolam (MDZ) is a short-acting benzodiazepine that is widely used to induce and maintain general anesthesia during diagnostic and therapeutic procedures in pediatric patients due to its sedative properties. The aim of this study was to perform a systematic review without a meta-analysis to identify scientific articles and clinical assays concerning MDZ-induced sedation for a pediatric surgery approach. One hundred and twenty-eight results were obtained. After critical reading, 37 articles were eliminated, yielding 91 publications. Additional items were identified, and the final review was performed with a total of 106 publications. In conclusion, to use MDZ accurately, individual patient characteristics, the base disease state, comorbidities, the treatment burden and other drugs with possible pharmacological interactions or adverse reactions must be considered to avoid direct alterations in the pharmacokinetics and pharmacodynamics of MDZ to obtain the desired effects and avoid overdosing in the pediatric population.


Adverse reactions; BIS, Bispectral index; CL, Clearance; CNS, Central nervous system; EEG, Electroencephalogram; GABA, Gamma-aminobutyric acid; MDZ, Midazolam; Midazolam; NONMEM, Nonlinear mixed effects modeling; Pediatrics; Pharmacokinetics-pharmacodynamics; Pharmacological interactions; PopPK, Population pharmacokinetics; Sedation; Vd, Distribution volume; t1/2, Elimination half-life.

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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