Effect of oral midazolam premedication on the awakening concentration of sevoflurane, recovery times and bispectral index in children

Abstract

There were no significant differences between groups in awakening time, sevoflurane or N2O awakening concentrations, time to PACU discharge, time to hospital discharge or in BIS I and BIS E measurements.

The relationship between bispectral index and endtidal concentration of sevoflurane during anesthesia and recovery in spontaneously ventilating children

“…The mean BIS awake value of 69 was low compared with those reported in other pediatric studies, which are frequently about 80 (2–4,8,9). In fact our BIS awake was in the same range as preawakening BIS values seen in other studies (4,9), probably because we recorded the BIS value averaged over the 30 s preceding awakening.…”

“…Brosius et al. showed variability of BIS values in children during equilibration of 3% sevoflurane in 60% N 2 O/40% O 2 (3), as did Denman et al. when using steady‐state PE sevo levels to study dose–effect relationships between PE sevo and BIS (2).…”

“…Another possible explanation for our low BIS awake was use of premedication. In preadolescents BIS awake was found to be significantly lower when premedication was given (5), but this difference was not found in younger children (3), and in contrast with the preawakening period the differences were nonsignificant at awakening (9).…”

Performance of entropy and Bispectral Index as measures of anaesthesia effect in children of different ages

“…One study in children age 1-10 yr found no large effects on BIS at awakening or at set sevoflurane concentrations. 6 The same authors reported no effect on intraoperative BIS but a lower BIS on awakening in children aged 10-18 yr. 8 Rodriguez and colleagues 7 reported the opposite: a lower value prearousal in those who had received midazolam. However, this result is confounded by the increased use of sedation in younger children.…”

AEP‐monitor/2 derived, composite auditory evoked potential index (AAI‐1.6) and bispectral index as predictors of sevoflurane concentration in children

“…Premedication was with paracetamol, and midazolam if indicated. In theory midazolam may affect the EEG, however previous studies have not demonstrated any affect of midazolam premedication on the relationship between EEG and sevoflurane concentration during anesthesia or the relation ship between EEG and awakening (3,9). Induction of anesthesia was with sevoflurane, with or without nitrous oxide and the trachea was intubated with or without atracurium.…”