Oral midazolam and oral butorphanol premedication

Singh, Vinita; Pathak, Manu; Singh, Gurmeet

doi:10.1007/bf02734144

Cited by 11 publications

(14 citation statements)

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“…Benzodiazepines, used solely or in combination, were the most well-studied drugs: only 7 out 54 trials did not include a benzodiazepine group [13,17,30,38,46,49,65]. Drugs currently used in clinical practice are reported in the following studies: midazolam was investigated in 33 trials [7, 14–16, 19, 27, 28, 31, 33, 35, 39–45, 47, 48, 50–54, 59, 61, 63, 66–71], nitrous oxide in seven [26, 30, 34, 42, 46, 50, 51], ketamine in eight [13–17, 26, 34, 37, 44, 49, 70], dexmedetomidine in one [49] and propofol in four [13, 14, 46, 47]. Besides, all drugs investigated in 23 studies were the ones currently used: 19 involved midazolam [7, 19, 27, 31, 33, 35, 40, 41, 50–52, 54, 61, 63, 66–70], three nitrous oxide [46, …”

Section: Resultsmentioning

confidence: 99%

“…Benzodiazepines were compared to non-benzodiazepines in 13 studies [18,44,45,48,50,51,56–60,70,71]. In four studies, anterograde amnesia was significantly more likely when benzodiazepines were used than when nitrous oxide [50], antihistamines [45,48,60], or triclofos [48] were used.…”

Section: Resultsmentioning

confidence: 99%

“…In four studies, anterograde amnesia was significantly more likely when benzodiazepines were used than when nitrous oxide [50], antihistamines [45,48,60], or triclofos [48] were used. However, one study showed the anterograde amnesia was less likely to occur when benzodiazepines were used than when butorphanol was used [71]. …”

Section: Resultsmentioning

confidence: 99%

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What is the level of evidence for the amnestic effects of sedatives in pediatric patients? A systematic review and meta-analyses

et al. 2017

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BackgroundStudies have suggested that benzodiazepines are amnestic drug par excellence, but when taken together, what level of evidence do they generate? Are other sedatives as amnestic as benzodiazepines? The aim of this study was to assess the level of scientific evidence for the amnestic effect of sedatives in pediatric patients who undergo health procedures.MethodsThe literature was searched to identify randomized controlled trials that evaluated anterograde and retrograde amnesia in 1-19-year-olds who received sedative drugs during health procedures. Electronic databases, including PubMed, Scopus and Cochrane Library besides clinical trial registries and grey literature were searched. Two independent reviewers performed data extraction and risk of bias assessment using the Cochrane Collaboration's Tool. The meta-analyses were performed by calculating relative risk (RR) to 95% confidence intervals (CI). The quality of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation approach.ResultsFifty-four studies were included (4,168 participants). A higher occurrence of anterograde amnesia was observed when benzodiazepines, the most well-studied sedatives (n = 47), were used than when placebo was used (n = 12) (RR = 3.10; 95% CI: 2.30–4.19, P<0.001; I2 = 14%), with a moderate level of evidence. Higher doses of alpha2-adrenergic agonists (clonidine/dexmedetomidine) produced more anterograde amnesia than lower doses (n = 2) (RR = 1.83; 95% CI: 1.03–3.25; P = 0.038; I2 = 0%), with a low level of evidence; benzodiazepines’ amnestic effects were not dose-dependent (n = 3) (RR = 1.54; 95% CI: 0.96–2.49; P = 0.07; I2 = 12%) but the evidence was low. A qualitative analysis showed that retrograde amnesia did not occur in 8 out of 10 studies.ConclusionsIn children, moderate evidence support that benzodiazepines induce anterograde amnesia, whereas the evidence for other sedatives is weak and based on isolated and small studies. Further clinical trials focused on the amnesia associated with non-benzodiazepine sedatives are therefore needed.Trial registrationPROSPERO CRD42015017559.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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What is the level of evidence for the amnestic effects of sedatives in pediatric patients? A systematic review and meta-analyses

et al. 2017

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“…It has been used orally as an analgesic for chronic/cancer pain,[17] but there is only one study in literature on its efficacy as a pediatric premedication. [18]…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of midazolam and butorphanol as oral premedication in pediatric patients

Sinha

Kaur

Kumar

et al. 2012

J Anaesthesiol Clin Pharmacol

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Background:To compare oral midazolam (0.5 mg/kg) with oral butorphanol (0.2 mg/kg) as a premedication in 60 pediatric patients with regards to sedation, anxiolysis, rescue analgesic requirement, and recovery profile.Materials and Methods:In a double blinded study design, 60 pediatric patients belonging to ASA class I and II between the age group of 2–12 years scheduled for elective surgery were randomized to receive either oral midazolam (group I) or oral butorphanol (group II) 30 min before induction of anesthesia. The children were evaluated for levels of sedation and anxiety at the time of separation from the parents, venepuncture, and at the time of facemask application for induction of anesthesia. Rescue analgesic requirement, postoperative recovery, and complications were also recorded.Results:Butorphanol had better sedation potential than oral midazolam with comparable anxiolysis at the time of separation of children from their parents. Midazolam proved to be a better anxiolytic during venepuncture and facemask application. Butorphanol reduced need for supplemental analgesics perioperatively without an increase in side effects such as nausea, vomiting, or unpleasant postoperative recovery.Conclusion:Oral butorphanol is a better premedication than midazolam in children in view of its excellent sedative and analgesic properties. It does not increase side effects significantly.

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“…12,13 Se das yon ama cıy la mi da zo lam (%85), ke ta min (%4), transmu ko zal fen ta nil (%3), me pe ri din (%2) ter cih edilmek te dir. [13][14][15] Kriterler Puanlar …”

Section: Tar Tiş Maunclassified

Dental Treatment in Patients with Mental Retardation: A Retrospective Study

Çağiran¹,

Efeoğlu²,

Balcioglu³

et al. 2011

Turkiye Klinikleri J Med Sci

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830Mental Retarde Hastalarda Dental Tedavi:Retrospektif İnceleme Ö ÖZ ZE ET T A Am ma aç ç: : Men tal re tar de has ta lar da ko o pe ras yon güç lü ğü ne de niy le den tal te da vi ler sık lık la gü nü-bir lik ge nel anes te zi al tın da ya pı lır. Bu ça lıs ma da 2006-2009 yıl la rı ara sın da Ege Üni ver si te si Diş Hekim li ği Fa kül te si Ağız Diş Çe ne Has ta lık la rı Cer ra hi si Ana Bi lim Da lı ge nel anes te zi üni te sin de te da vi edi len, men tal re tar de ol gu la rın ret ros pek tif ola rak bil di ril me si amaç lan mış tır. G Ge e r re eç ç v ve e y yö ön n t te em m l le er r: : Ça lış ma mı za Ocak 2006 -Ka sım 2009 ta rih le ri ara sın da, ana bi lim da lı mız ge nel anes te zi üni te sin de diş te da vi si ol muş 330 men tal re tar de ol gu da hil edil miş tir. Bu ol gu la rın ka yıt la rı ret ros pek tif ola rak in celen miş tir. De mog ra fik ve ri le ri, ASA sı nıf lan dır ma sı (Ame ri kan Anes te zi yo lo ji Der ne ği Has ta Du rum Sı-nıf lan dır ma sı), yan daş has ta lık lar, ya pı lan den tal te da vi ler, gi ri şim sü re si, in tra o pe ra tif ve pos to pe ra tif komp li kas yon lar ve PATSS (pos ta nes te zi ta bur cu luk skor la ma sis te mi) sü re si de ğer len di ri le rek el de edi len ve ri ler or ta la ma ± stan dart sap ma (SS) ya da sa yı ola rak kay de dil miş tir. B Bu ul l g gu u l la ar r: : Ça lış ma da yer alan 330 ol gu nun yaş or ta la ma sı 18.13±16 ve ka dın/er kek ora nı 156/ 174 ol muştur. Ol gu la rın 275'i (%83.3) ASA I, 55'i ise (%16.7) ASA II ola rak sı nıf lan dı rıl mış tır. Or ta la ma ope ras yon sü re si 99.5 ± 40.4 da ki ka, PATSS sü re si ise 119.6 ± 23.6 da ki ka ola rak he sap lan mıs tır. Has ta la rın altısın da en tü bas yon güç lü ğü sap tan mıs, bir has ta ise en tü be edi le me ye rek uyan dı rıl mıs tır. Has ta ba şı na ya pı lan çe kim sayı sı 3.08 ± 1.9, dol gu sa yı sı 2.35 ± 2 ol muş tur. Has ta la rın pos to pe ra tif iz le min de bu lan tı-kus ma 28 hasta da (%8.5) sap tan mış tır.S So o n nu uç ç: : Doğ ru has ta se çi mi ve anes te zi pla nı ile men tal re tar de has ta la rın gü nü bir lik ge nel anes te zi al tın da diş te da vi le ri gü ven le uy gu la na bil mek te dir.

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Oral midazolam and oral butorphanol premedication

Abstract: Oral butorphanol is comparable to oral midazolam in children but analgesia along with sedation is an additional advantage which makes it better than midazolam without a significant increase in side effects.

Cited by 11 publications

References 11 publications

What is the level of evidence for the amnestic effects of sedatives in pediatric patients? A systematic review and meta-analyses

What is the level of evidence for the amnestic effects of sedatives in pediatric patients? A systematic review and meta-analyses

Comparative evaluation of midazolam and butorphanol as oral premedication in pediatric patients

Dental Treatment in Patients with Mental Retardation: A Retrospective Study

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