Administration and conversion of paediatric sedation using benzodiazepines

Check your answers on page 218https://doi.org/10.12968/jprp.2024.6.5.194

Benzodiazepines are commonly used medications that potentiate the effect of GABA to decrease neuronal excitability and activity. They can be used acutely to treat insomnia or control seizures, or in acute care settings as an intravenous sedation.

If patients have been sedated for prolonged periods, abrupt discontinuation is undesirable as withdrawal could be precipitated. However, there will also be situations in which patients will need to have intravenous access withdrawn before being fully weaned from an intravenous benzodiazepine, and in such cases it can be useful to convert a patient to an alternate agent while facilitating a wean.

The following case calculation considers a situation in which a 7.2 kg patient is on a midazolam infusion and there is an intention to convert a patient to oral diazepam.

If the patient has a syringe set up which contains 45 mg/50 ml of midazolam and is running at 1.5 ml/hour, what is the dose the patient is receiving in microgram/kg/hour?