A Comparative Study on the Sedative Efficacy of Midazolam and Chloral Hydrate in Pediatric VCUG
| Author | Mahdi Aghagoli | en |
| Author | Fatemeh Safi | en |
| Author | Parsa Yousefichaijan | en |
| Author | Hamidreza Jamilian | en |
| Author | Mohammad Rafiei | en |
| Author | Masoud Rezagholizamenjany | en |
| Orcid | Parsa Yousefichaijan [0000-0002-6243-431X] | en |
| Orcid | Masoud Rezagholizamenjany [0000-0002-5824-2366] | en |
| Issued Date | 2026-08-31 | en |
| Abstract | Background: Voiding cystourethrography (VCUG) is the gold-standard imaging technique for diagnosing vesicoureteral reflux (VUR) in children. Because the procedure can cause substantial anxiety and discomfort, pharmacologic and nonpharmacologic approaches are used to improve cooperation and reduce distress. Objectives: This study aimed to compare the sedative effects of midazolam and chloral hydrate in children undergoing VCUG. Methods: This randomized, single-blind clinical trial included 150 children aged 2 - 12 years with indications for VCUG. Participants were randomly assigned to three groups: intramuscular midazolam, oral chloral hydrate, and a control group. Baseline demographic characteristics, child cooperation during VCUG across three procedural stages, ease of separation from parents on a 4-point scale, postvoid residual urine volume, and adverse drug reactions were recorded. Data were analyzed using SPSS version 26. Results: A total of 150 children were enrolled, with comparable baseline characteristics among the groups (P > 0.05). Midazolam resulted in significantly better cooperation during catheterization (82%), image acquisition (78%), and urination (88%) than chloral hydrate (56%, 54%, and 48%, respectively) and the control group (12%, 22%, and 14%, respectively). Compared with the control group, midazolam significantly increased the odds of good cooperation during catheterization (odds ratio [OR], 33.6; 95% CI, 11.0 - 102.5; P = 0.023), image acquisition (OR, 12.6; 95% CI, 4.8 - 33.4; P = 0.041), and urination (OR, 45.6; 95% CI, 13.9 - 149.2; P < 0.001). Ease of separation from parents also improved with midazolam (64% vs 16%; OR, 9.9; 95% CI, 3.9 - 25.0; P < 0.001). Postvoid residual urine volume did not differ significantly among the groups (P = 0.51). Only 1 mild adverse event, skin erythema, occurred in the chloral hydrate group. Conclusions: Midazolam and chloral hydrate significantly improved children’s cooperation and tolerance during VCUG without affecting voiding function or increasing complications. Midazolam showed a more pronounced beneficial effect than chloral hydrate, making it the preferred sedative for pediatric VCUG. | en |
| DOI | https://doi.org/10.5812/jcp-168219 | en |
| URI | https://brieflands.com/journals/jcp/articles/168219 | en |
| Keyword | Midazolam | en |
| Keyword | Chloral Hydrate | en |
| Keyword | Voiding Cystourethrography | en |
| Keyword | Children | en |
| Keyword | Sedation | en |
| Publisher | Brieflands | en |
| Title | A Comparative Study on the Sedative Efficacy of Midazolam and Chloral Hydrate in Pediatric VCUG | en |
| Type | Research Article | en |
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