Background: Selecting the best medication for upper GI endoscopy in children is a challenging issue. The goal of this study was to compare the effects of oral and intravenous midazolam for upper gastrointestinal endoscopy (UGIE) on children.

Methods: In this randomized clinical trial study conducted in Amirkola Children's Hospital, 110 children were randomly assigned to oral or intravenous groups. An expert nurse recorded O2 saturation, heart rate before, during and 5 minutes after endoscopy for all patients. Sedation, separation from parents and child cooperation were recorded.

Results: Heart rate before and during endoscopy was not significantly different between two groups while heart rate was significantly lower in IV group after endoscopy. Cooperation during bite block was significantly better in oral group. Cooperation during endoscopy was not significantly different between two groups. Separation from parents in both male and female ones was significantly better in oral group. Complications were reported in 7 cases in oral group and 6 in IV group.

Conclusion: Oral midazolam in comparison with IV midazolam is better and may be a method of choice for pediatric UGIE purposes.