Preanesthetic sedation of preschool children: Comparison of intranasal midazolam versus oral promethazine

Abstract

Background:Ensuring adequate preoperative sedation and anxiolysis is essential, especially in pediatric surgery. Various drugs and routes of administration have been evaluated to determine the optimal method of sedation.Materials and Methods:We selected hundred preschool children undergoing elective surgery and sedated them with either intranasal midazolam or oral promethazine syrup in the preoperative period. They were assessed with respect to their levels of sedation till the period of mask placement for induction of general anesthesia.Results:Both groups had comparable heart rates, respiratory rates, sedation scores, and emotional scores at all points of assessment (P>0.05). However, intranasal midazolam had a significantly shorter onset of sedation as well as time to reach maximal sedation (P<0.001).Conclusion:We conclude that either drug may be used with ease in preschool children undergoing elective surgery.

(119) A Comparative Study on the Sedative Effect of Oral Midazolam and oral Promethazine Medication in lumbar puncture

“…Patients of the first group received oral midazolam syrup 0.5 mg/kg, 50 minutes before LP (9) and in the second group, patients received oral promethazine syrup 1 mg/kg, 90 minutes before the procedure (5). …”

“…Gutstein et al’s five-point sedation scale (1992) was used in both groups to evaluate the children’s sedation levels (5,13), 30, 25, 20, 15, 10 and 5 minutes before the LP.…”

“…LPs are essentially painful and in some children can cause severe anxiety and distress (2-4) that can continue for months after the procedure (5). …”

“…This medication has been reported as an effective and safe sedative drug with low complications (5). …”

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“…12 In this case, either intranasal midazolam 0.3mg/kg, 30 minute prior to induction of general anesthesia or oral promethazine surup 1mg/kg, 90 minute prior to induction of general anesthesia was given to chosen children undergoing elective surgery. The study concluded that either midazolam or promethazine may be used as premedication as both of them are efficacious drugs.…”