Comparison of intravenous midazolam with pentobarbital for sedation for head computed tomography imaging

Donna M. Moro-Sutherland, John T. Algren, Penelope T. Louis, Claudia A. Kozinetz, Joan E. Shook

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Objective: To compare the efficacy of intravenous (IV) midazolam with that of IV pentobarbital when used for sedation for head computed tomography (CT) imaging in emergency department (ED) pediatric patients. Methods: Prospective, randomized clinical trial in an urban children's hospital. During a two-and-a-half-year period, 55 patients were enrolled: 34 males and 21 females. Measurements included induction time, recovery time, efficacy, side effects, complications, and failure with each drug. Success of sedation was graded as good (GS), adequate (AS), poor (PS), or unsuccessful (US). Results: Sedation for CT was used for patients with the following problems: head trauma (21/55), central nervous system pathology (17/55), ventriculoperitoneal shunt evaluation (6/55), periorbital cellulitis (6/55), and retropharyngeal abscess (5/55). Twenty-nine (53%) patients received pentobarbital (mean ± SD dose 3.75 ± 1.10 mg/kg) and 26 (47%) patients received midazolam (mean ± SD dose 0.2 ± 0.03 mg/kg). In the pentobarbital group, 28 (97%) patients were scanned and successfully sedated. Pentobarbital's mean induction time was 6 minutes and duration of sedation averaged 86 minutes. In the midazolam group, only five (19%) patients were successfully scanned with midazolam alone. Of the 21 (81%) patients given midazolam who were unsuccessfully sedated, 12 (61%) were subsequently sedated with the addition of pentobarbital for completion of CT imaging. Mild oxygen desaturatlon, O2 sat >90% yet <94%, was seen in only four patients. All four patients responded to blow-by oxygen and required no other intervention. Conclusion: Intravenous pentobarbital is more effective than IV midazolam for sedation of children requiring CT imaging.

Original languageEnglish (US)
Pages (from-to)1370-1375
Number of pages6
JournalAcademic Emergency Medicine
Issue number12
StatePublished - 2000
Externally publishedYes


  • Computed tomography imaging
  • Midazolam
  • Pediatrics
  • Pentobarbital
  • Sedation

ASJC Scopus subject areas

  • Emergency Medicine


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