Research conducted within the Canadian healthcare system highlights intranasal midazolam (INM) as the most economical option for managing anxiety during pediatric laceration repairs. This study evaluated four different anxiolytic medications to determine their impact on hospital length of stay (LOS) and associated costs.
Comparing Medications’ Costs and Efficiency
The analysis encompassed intranasal midazolam, inhaled nitrous oxide (N₂O), intranasal dexmedetomidine, and intravenous ketamine (IVK). Findings indicate that N₂O resulted in the shortest LOS at approximately 78 minutes, while INM followed closely at 82 minutes. Dexmedetomidine and IVK extended the hospital stay to 115 and 103 minutes, respectively. Cost-wise, INM proved to be the most affordable at $123 per patient, outperforming N₂O ($177), IVK ($167), and dexmedetomidine ($165).
Uncertainties Highlight Need for Further Research
The study faced limitations due to the low quality of existing evidence, particularly concerning procedure times associated with N₂O and IVK. This uncertainty suggests a need for more comprehensive research to solidify these findings and guide clinical decision-making effectively.
• INM offers the lowest cost without significantly increasing LOS.
• N₂O provides the quickest procedure times, beneficial for high-traffic emergency departments.
• The limited quality of evidence necessitates cautious interpretation of results.
Healthcare providers can consider INM as a cost-saving alternative while maintaining effective sedation for pediatric patients. The balance between cost and efficiency is crucial, especially in resource-limited settings. As the study underscores, enhancing the quality of evidence through further research will enable more informed choices, potentially improving patient outcomes and optimizing resource allocation within emergency departments.
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