Oral midazolam compared with diazepam‐droperidol and trimeprazine as premedicants in children

Abstract

Ninety children were assigned randomly to one of three groups for premedication with oral midazolam 0.5 mg.kg-1, diazepam 0.25 mg.kg-1 with droperidol 0.25 mg.kg-1, or trimeprazine 2 mg.kg-1. On arrival at the anaesthetic room, anxiolysis was satisfactory in 26 out of 29 (90%) children who received midazolam compared with 23 out of 29 (79%) who received diazepam-droperidol and 18 out of 29 (62%) who received trimeprazine (P < 0.05); at induction of anaesthesia these proportions were 24 out of 29 (83%), 16 out of 29 (55%) and 11 out of 29 (40%) respectively (P < 0.001). When individual groups were compared, anxiolysis was significantly greater in the midazolam group compared with the trimeprazine group on arrival in the anaesthetic room (P < 0.05) and significantly greater in the midazolam group than in either the diazepam-droperidol or the trimeprazine groups at induction of anaesthesia (P < 0.05 and P < 0.001 respectively). There were no significant differences in times to early recovery between the groups (25.4, 24.4 and 28.5 min). Analysis of behavioural questionnaires completed two weeks after hospitalization showed a trend towards fewer postoperative behavioural disturbances in children who received midazolam or diazepam-droperidol compared with trimeprazine (47 and 44% vs 75%); when the results for the benzodiazepine-containing premedicants were combined, the difference between these groups and trimeprazine was statistically significant (P < 0.05).

Oral Midazolam Premedication for Children Undergoing General Anaesthesia for Dental Care

“…It was also associated with a faster and smoother recovery, when compared with oral ketamine [14]. Patel and Meakin [15] also reported greater anxiolysis after oral midazolam (0.5 mg/kg) than after a combination of diazepam (0.25 mg/kg) with droperidol (0.25 mg/kg) or trimeprazine (2 mg/kg).…”

Are antihistamines effective in children? A review of the evidence

“…These trials found conflicting results with some reporting short-term improvement while on alimemazine 15–19. Alimemazine has been shown to have the sedative effect, necessary for the use as a premedicant in children 20 21. In addition, in a randomised placebo-controlled trial with 15 children, alimemazine caused relief of retching after Nissen fundoplication 22.…”

Comparative Study of Effects of Midazolam and Ketamine as Oral Premedication for Paediatric Anaesthesia

“…Patel and Meakin also reported greater anxiolysis after oral midazolam than after a combination of diazepam and droperidol or trimeprazine. (12) The incidence of secretion was observed to be 24% with oral ketamine as compared to 6% with oral midazolam. C Suresh et al has shown increased secretions in 20% cases with 6 mg/kg of oral ketamine.…”