Effect of premedication with oral midazolam on preoperative anxiety in children with history of previous surgery – A prospective study

Padhi, Pulak Priyadarshi; Bhardwaj, Neerja; Yaddanapudi, Sandhya

doi:10.4103/ija.ija_529_18

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…The anxiety scores were similar after premedication with midazolam in children with history of anesthesia and those who experienced anesthesia for the first time. However, the overall anxiety was reduced after receiving midazolam (13).…”

Section: Discussionmentioning

confidence: 90%

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A Double-Blind Clinical Trial to Determine the Effect of Oral Zolpidem and Midazolam on the Level of Preoperative Anxiety in Children Undergoing Eye Examination Under General Anesthesia

et al. 2020

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Background: Preoperative anxiety is a very important factor in pediatric surgery; 40% - 60% of children experience a high level of anxiety in the preoperative period. Objectives: Given the need for anxiety control in children and considering that limited studies have been conducted in this regard, this research was performed to compare the effect of oral zolpidem and midazolam on level of preoperative anxiety in children. Methods: In a prospective double-blind randomized controlled trial, 56 cases were randomly divided into two groups of 28 participants. A group underwent zolpidem premedication and the other underwent midazolam premedication. The level of preoperative and postoperative anxiety was measured by MYPAS SCORE checklist and compared. Results: The study comprised 56 patients (19 girls and 37 boys) aged between 3 - 9 years. The mean score of anxiety in the group receiving midazolam was 63.80 in pre-test and 32.61 in post-test (P < 0.001). The mean score of anxiety in the group receiving zolpidem was 62.49 in pre-test and 30.94 in post-test (P < 0.001). Mean anxiety in the patients of zolpidem group was lower than that in midazolam group (P < 0.001). Conclusions: Our results show that both zolpidem and midazolam reduce preoperative anxiety, however, the preoperative anxiety was significantly decreased after taking zolpidem in comparison with midazolam. Zolpidem is a hypnotic drug with rapid onset and short duration of action, which might be an alternative premedication for midazolam in pediatric anesthesia, particularly when the reduced anxiety and child cooperation are needed.

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Section: Discussionmentioning

confidence: 90%

“…The drug was given to the patients at a relatively low dose to prevent excessive sedation that might mask the symptoms of anxiety and would not be obvious to others, including researchers collecting information. Therefore, the dose of drug was set to a value less than similar studies (6,13,14).…”

Section: Discussionmentioning

confidence: 99%

A Double-Blind Clinical Trial to Determine the Effect of Oral Zolpidem and Midazolam on the Level of Preoperative Anxiety in Children Undergoing Eye Examination Under General Anesthesia

et al. 2020

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“…[ 7 ] The methods to reduce anxiety can be pharmacological or nonpharmacological (behavioral). [ 10 ] Pharmacological interventions include premedication with midazolam (oral or intravenous route), ketamine, or dexmedetomidine. [ 11 ] Nonpharmacological interventions include psychological interventions such as distraction, hypnosis, environmental interventions, equipment modifications, and social interventions.…”

Section: Introductionmentioning

confidence: 99%

“…The various nonpharmacological methods have been studied in isolation; however, their relative efficacy in comparison to pharmacological agents remains to be proven. [ 10 13 ] Literature on the comparison of sedative premedication given by intravenous route with a nonpharmacological method remains scarce. The purpose of this study was to compare the effectiveness of a pharmacological intervention (midazolam), and a behavioral intervention (parental presence) for reducing the anxiety in children undergoing surgery under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study on Effectiveness of Parental Presence versus Sedative Premedication for Reducing Anxiety in Children Undergoing General Anesthesia

Jain,

Patel,

Arora

et al. 2023

International Journal of Applied &Amp; Basic Medical Research

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Background: Preoperative anxiety is an important, yet often unattended problem in children. Minimizing anxiety and distress at the time of anesthetic induction may reduce adverse psychological and physiological outcomes. Sedative premedication and parental presence during anesthesia induction are among the most commonly employed strategies for reducing child anxiety. Aims and Objective: The study aimed to compare the effectiveness of a pharmacological intervention (premedication with midazolam) versus behavioral intervention (parental presence) in reducing preoperative anxiety in children undergoing general anesthesia. Methodology: Sixty patients of age group of 4–12 years, of ASA Grade 1 and 2 and either sex posted for elective surgery under general anesthesia were divided into two groups of 30 each Group M (midazolam group) and Group P (parental presence). Group M received intravenous midazolam 0.03–0.05 mg/kg preoperatively and anxiety was measured in preoperative room, during separation from parents and during introduction of anesthesia mask, whereas in Group P, parents accompanied the child inside the operation theater and anxiety was measured at preoperative room and during introduction of mask. Parental anxiety was measured in both groups at preoperative room and waiting room. Modified Yale Preoperative Anxiety Scale (mYPAS) and State Trait Anxiety Inventory (STAI) tool was used to measure anxiety in children and parents, respectively. Results: The mean mYPAS score while the introduction of anesthesia mask in Group M was 31.30 ± 12.04 and in Group P was 63.19 ± 25.31, and the difference was found to be statistically significant (P = 0.001). In preoperative room, there was no significant difference in anxiety in the two study groups. The mean STAI score in Group P was 45.63 ± 1.45 and in Group M was 41.10 ± 1.69, and the difference was found to be statistically significant (P = 0.001). In preoperative room, parental anxiety was found to be comparable among the two groups. The mean duration of induction of anesthesia in Group M was 5.53 ± 1.01 min, and in Group P, it was 8.77 ± 2.03 min. The difference was found to be statistically significant (P = 0.001). Conclusion: Both interventions were effective in reducing anxiety in children, but midazolam was more effective compared to parental presence. Parents in Group M were less anxious in the waiting room than Group P. Children in Group M were more compliant during the induction of anesthesia, hence a lesser duration of induction than Group P.

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A Prospective Study on Effect of Premedication With Oral Midazolam on Preoperative Anxiety in Children With History of Previous Surgery

Anpuram¹

2019

jebmh

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BACKGROUND Addressing child anxiety during medical procedures is a growing trend and dental treatment is no exception. MATERIALS AND METHODS Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/Kg, while children of the control group were premedicated with a placebo. Scores for parental separation, mask acceptance, postoperative emergence delirium, and time spent in the post-anaesthesia care unit were compared statistically. RESULTS Anxiety scores after premedication were statistically insignificant in children without a history of previous surgery and in those with a history of previous surgery. Baseline anxiety scores were comparable in the two groups. CONCLUSION Anxiety scores after premedication with midazolam were similar in children with history of previous anaesthesia exposure and those experiencing anaesthesia for the first time. Anxiety was compared after premedication in children with a history of previous surgery and those without a history of previous surgery.

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Effect of premedication with oral midazolam on preoperative anxiety in children with history of previous surgery – A prospective study

Cited by 5 publications

References 16 publications

A Double-Blind Clinical Trial to Determine the Effect of Oral Zolpidem and Midazolam on the Level of Preoperative Anxiety in Children Undergoing Eye Examination Under General Anesthesia

A Double-Blind Clinical Trial to Determine the Effect of Oral Zolpidem and Midazolam on the Level of Preoperative Anxiety in Children Undergoing Eye Examination Under General Anesthesia

A Comparative Study on Effectiveness of Parental Presence versus Sedative Premedication for Reducing Anxiety in Children Undergoing General Anesthesia

A Prospective Study on Effect of Premedication With Oral Midazolam on Preoperative Anxiety in Children With History of Previous Surgery

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