Oral midazolam premedication for paediatric day case patients

Abstract

Forty-nine children having day-stay surgical procedures were randomly assigned to receive oral midazolam 0.75 mg.kg-1 or placebo in a double blind fashion. The child's level of anxiety was assessed before premedication using parental, child and observer scales. The child and observer anxiety scores were repeated in the anaesthetic room. Most children presented for anaesthesia in a calm state, irrespective of whether they had received midazolam. Parents tended to overestimate their child's level of anxiety. Observer anxiety scores reliably predicted behaviour during induction of anaesthesia in the absence of a sedative. Observer scores decreased in the midazolam group (P < 0.02), but not in the placebo group, children below six years having the greatest decrease with midazolam. The median time to discharge from hospital was delayed by 30 min in the midazolam group (P < 0.01). Children do not require routine sedative premedication for day case procedures, but oral midazolam is useful in producing calm behaviour in those children with high observer anxiety scores.

Effectiveness of premedication agents administered prior to nitrous oxide/oxygen

“…1 In anaesthetic applications in paediatric patients, oral midazolam is reported in a wide range of 0.2-1 mg kg À1 . 15 Day et al 16 reported that in the high-anxiety level group aged 2.9 AE 1.6 a dose of 0.2-0.3 mg kg À1 and in the age group 5 AE 1 a dose of 0.5-0.7 mg kg À1 midazolam is appropriate for sedative premedication. In the second group of our study, 0.7 mg kg À1 midazolam was applied.…”

Premedication with midazolam in young children: a comparison of four routes of administration

“…(10) and Cray et al . (13). With regard to mask acceptance, our results (77–83%) are similar to those of Karl et al .…”

Effect of flumazenil on recovery from sevoflurane anesthesia in children premedicated with oral midazolam before undergoing herniorrhaphy with or without caudal analgesia

“…The oral administration of midazolam is widely used for this purpose because of its rapid onset, short duration of action, and lack of significant side effects [1][2][3][4]. However, previous studies have shown contradictory effects of oral midazolam premedication on the quality of recovery from sevoflurane-induced anesthesia [5][6][7].…”