Comparison of the effect of oral diphenhydramine and midazolam on sedation of children


  • Neda Naeimi Bafghi Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran.
  • Naeimeh NaeimiBafghi Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran.
  • Shirin Salajegheh Clinical Research Center, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran.



Diphenhydramine, midazolam, sedation


Objectives:  The aim of this study was to compare the effect of diphenhydramine and midazolam on sedation of children.

Methods: This clinical trial was performed on children aged 1 to 7 years who referred to the emergency department for diagnostic radiology. Patients were randomly divided into two groups of midazolam and diphenhydramine. Then, 30 minutes before the start of the procedure, 0.5 mg /kg was given to the midazolam group and 0.5 cc /kg to the diphenhydramine group. If sedation occurred, the child was separated from the parents and transferred to a diagnostic procedure. After performing the intended diagnostic procedure, the information sheet was completed and the patient's vital signs were checked again. The data were then analyzed by SPSS version 19 software.

Results: A total of 74 patients were included in the study. There was no significant difference between the two groups in terms of age and gender (P = 0.89; P = 0.32). The mean sedation in the midazolam and diphenhydramine groups was 1.02 and 1.59 years, respectively. A significant difference was found between the two groups in terms of sedation (P = 0.04), where a greater effect of diphenhydramine on sedation was observed.

Conclusion: The findings showed that the use of diphenhydramine resulted in effective sedation for children. Due to the fact that the main problem with midazolam is its bitter taste, which makes children reluctant to eat it, the use of diphenhydramine can be recommended


1- Song JH. Procedural sedation and analgesia in children. J Korean Med Assoc. 2013;56(4):271-8.
2- Eskandarian T, Maghsoudi S, Eftekharian H. Clinical evaluation of the effects of two types of oral combination of midazolam in sedating pediatric dental patients. J Dent Shiraz Univ Med Sci. 2010; 11(1).
3- Soleimanpour H, Gholipouri C, Salarilak S, Raoufi P, Vahidi RG, Rouhi AJ, et al. Emergency department patient satisfaction survey in Imam Reza Hospital, Tabriz, Iran. Int J Emerg Med. 2011; 4:2.
4- Barkan S, Breitbart R, Brenner-Zada G, et al. A double-blind, randomised, placebo-controlled trial of oral midazolam plus oral ketamine for sedation of children during laceration repair. Emerg Med J. 2013; 31(8): 649-53.
5- Hosseini M, Karami Z, Janzadenh A, et al. The Effect of Intrathecal Administration of Muscimol on Modulation of Neuropathic Pain Symptoms Resulting from Spinal Cord Injury; an Experimental Study. Emergency. 2014; 2(4):151-7.
6- Alimohammadi H, Shojaee M, Samiei M, Abyari S, Vafaee A, Mirkheshti A. Nerve stimulator guided axillary block in painless reduction of distal radius fractures; a randomized clinical trial. Emergency. 2013; 1(1):11-4.
7- Azizkhani R, Esmailian M, Golshani K. Rectal Thiopental versus Intramuscular Ketamine in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial. Emergency. 2014; 3(1):22-6.
8- Khajavi M, Emami A, Etezadi F, Safari S, Sharifi A, Moharari RS. Conscious sedation and analgesia in colonoscopy: Ketamine/propofol combination has superior patient satisfaction versus fentanyl/propofol. Anesthesiol Pain Med. 2013; 3(1):208-12.
9- Alimohammadi H, Azizi M-R, Safari S, Amini A, Kariman H, Hatamabadi HR. Axillary Nerve Block in Comparison with Intravenous Midazolam/Fentanyl for Painless Reduction of Upper Extremity Fractures. Acta Med Iranica. 2014; 52(2):122- 4.
10- Krauss BS, Krauss BA, Green SM. Procedural sedation and analgesia in children. N Engl J Med. 2014; 370(15): e23.
11- Moreira TA, Costa PS, Costa LR, et al. Combined oral midazolam–ketamine better than midazolam alone for sedation of young children: a randomized controlled trial. Int J Paediatr Dent. 2013; 23(3):207-15.
12- Maurizi P, Russo I, Rizzo D, et al. Safe lumbar puncture under analgo-sedation in children with acute lymphoblastic leukemia. Int J Clin Oncol. 2014; 19(1):173-7.
13- Green SM. What is the role of diphenhydramine in local anesthesia? AcadEmerg Med. 1996; 3(3):198-200.
14- Alimohammadi H, Baratloo A, Abdalvand A, Rouhipour A, Safari S. Effects of Pain Relief on Arterial Blood O2 Saturation. Trauma mon. 2014; 19(1): e14034.
15- Cengiz M, Baysal Z, Ganidagli S. Oral sedation with midazolam and iphenhydramine compared with midazolam alone in children undergoing magnetic resonance imaging. Pediateric Anesthesia 2006;16(6) : 621 – 626 .
16- Golzari S, Shahsavari Nia K , Sabahi M, Soleimanpour H , Mahmoodpoor A, Safari S , et al. Oral Diphenhydramine-Midazolam Versus Oral Diphenhydramine for Pediatric Sedation in the Emergency Department. J ComprPed 2014 February; 5(1): e17946.
17- Heydarian N. Comparison of the simultaneous use of midazolam and oral diphenhydramine with oral midazolam in pediatric patients 1 to 7 years old at the time of CT scan referring to the emergency department of Besat Hospital. Army University of Medical Sciences, Thesis. 2014.
18- Taghipor¬ anvari Z, Sheibani S, Imani F, Sheibani S. Comparison of three Oral Premedication Dextrometorphan, Diphenhydramine and Midazolam in Pediatric Eye Exam under Anesthesia. JAP. 2011; 2 (3): 9-17.
19- Lane RD, Schunk JE. Atomized intranasal midazolam use for minor procedures in the pediatric emergency department. Pediatr Emerg Care. 2008 May; 24(5):300-3.
20- Plum AW, Harris TM. Intranasal midazolam for anxiolysis in closed reduction of nasal fractures in children. Int J Pediatr Otorhinolaryngol. 2015 Jul; 79(7):1121-3.
21- Musani IE, Chandan NV. A comparison of the sedative effect of oral versus nasal midazolam combined with nitrous oxide in uncooperative children. Eur Arch Paediatr Dent. 2015 May 5.




How to Cite

Naeimi Bafghi, N., NaeimiBafghi, N., & Salajegheh, S. (2021). Comparison of the effect of oral diphenhydramine and midazolam on sedation of children. Journal of Contemporary Medical Sciences, 7(4), 192–195.

Most read articles by the same author(s)