In a randomized, double-blind, placebo-controlled study, the safety, efficacy and feasibility of oral midazolam premedication in children were evaluated in an ambulatory surgery unit. Eighty unmedicated children (ASA PSI or II, were randomly assigned to one of four groups receiving midazolam 0.5, O. 75, or 1.0 The ideal premedicant for children scheduled for ambulatory surgery should: (1) be available in a preparation that is readily accepted by the children; (2) have a relatively rapid and reliable onset; (3) provide anxiolysis with mild sedative effects; (4) have anxiolytic and sedative effects of sufficient duration to accommodate delays in operating room scheduling without delaying discharge; (5) be free of side effects that would necessitate high levels of nursing supervision; and (6) provide for a rapid recovery and return to alertness postoperatively, thereby permitting early discharge from the recovery area. The parenteral CAN J ANAESTH 1992 / 39:6 / pp 545-50

To determine the minimum time interval between oral midazolam (0.5 mg" kg -~) Accepted for publication 16th April, 1993. prdmddication (valeur de base), au moment de la sdparation et pendant I'application du masque facial h l~nduction de I'anesthisie. Nous avons trouv~ que les changements de friquence cardiaque et de pression artdrielle systolique ont dtd semblables clans les trois groupes au cours de notre dtude. Le niveau de sddation d la sdparation et l'application du masque a dtd plus dlev~ que la valeur de base et n'est pas diffdrent entre les trois groupes. Le niveau d'anxiolyse n'a pas vari~ de la valeur de base d aucun moment dans les trois groupes. Nous concluons que les enfants peuvent ~tre sdpard de leurs parents aussi prdcocdment que 10 minutes aprds avoir re~u 0,5 mg" kg -1 de midazolam par voie oral.Oral midazolam is safe and effective for premedication of children scheduled for ambulatory surgery. 1.2 It has a rapid and reliable onset of action, few side effects and does not delay recovery. McMillan et al. demonstrated that oral midazolam in doses of 0.5, 0.75 and 1.0 mg-kg -1 produced excellent sedation and anxiolysis scores 15 min after administration to children 1-6 yr and at the time of separation from parents at 30 min. I However, the ease of separation from parents was assessed at only one time, 30 min after oral midazolam premedication. Similarly, Weldon et al. recommended that oral midazolam be given 30-45 min preoperatively) It has been our experience, however, that children could be separated from their parents less than 30 rain after receiving oral midazolam without compromising the degree of sedation and anxiolysis. We therefore sought to determine the minimum time interval between administration of oral midazolam (0.5 mg. kg -l) and separation of the children from their parents that would ensure a smooth and calm separation. MethodsThis randomized study was approved by the Human Subjects Review Committee and written parental consent was obtained. Midazolam (0.5 mg-kg -I) was administered to 30 children, ASA I or II and aged 1-6 years, who CAN J ANAESTH 1993 / 40:8 / pp 726-9