Manso MA, et al. - Researchers sought to assess the efficacy of oral midazolam for sedation in pediatric patients in the context of premedication before anesthesia or during diagnostic/treatment procedures via conducting a systematic review of the concerned literature. They estimated the percentage of responders (response rate) after single administration of oral midazolam and compared this with those with placebo in a subset of placebo-controlled studies. They selected a total of 25 pediatric clinical studies, which reported the use of a variety of measures of sedation effectiveness. In these studies, 1,472 patients (aged 4 months-18 years) treated with midazolam (0.25-1.5 mg/kg) and 138 patients treated with a placebo were included. With oral midazolam, response rates [95% confidence interval] ranging from 36.7% [21.6%, 54.9%] to 97.8% [86.1%, 99.7%], while with placebo, response rates ranging from 4.0% [0.6%, 23.5%] to 41.0% [29.4%, 53.6%] were evident. Findings demonstrate the efficacy of midazolam for pediatric minimal/moderate sedation from a dose of 0.25 mg/kg and above. With increasing doses, an increase in the probability of occurrence of adverse events and over-sedation was noted.