Temazepam and Trimeprazine Compared With Placebo as Premedication in Children

Padfield, Nick; Twohig, M. Mcd.; Fraser, Alyssa

doi:10.1093/bja/58.5.487

Cited by 36 publications

(20 citation statements)

References 17 publications

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“…3 Although we had made similar predictions for children in the placebo group undergoing mask induction in the present study, we were unable to test this hypothesis due to unacceptably low internal consistency values for this scale. In fact, internal consistency values were only marginal even for the emotionality and impulsivity scales on the EASI.…”

Section: Discussionmentioning

confidence: 66%

“…2 In children, excessive anxiety concerning the operation, including fear of anesthesia induction, can lead to postoperative maladaptive behavioural responses, and as such most children undergoing minor surgery and short hospitalization (72%-78%) demonstrate some behavioural changes during the first two weeks at home. 3,4 In children, preoperative anxiety has been related to negative physiological and psychological reactions following surgery, including nightmares, separation anxiety, eating problems, and increased fear of doctors. 5,6 Childhood temperament, the hereditary characteristics of an individual's nature, 7 has been found a useful predictor of how a child will react to a variety of potentially stressful situations.…”

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confidence: 99%

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High levels of impulsivity may contraindicate midazolam premedication in children

Finley¹,

Stewart²,

Buffett-Jerrott³

et al. 2006

Can J Anesth/J Can Anesth

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Purpose:To investigate the effects of midazolam on emotional reactivity during induction of anesthesia in a pediatric day surgery setting. A secondary purpose was to determine if these effects were influenced by child temperament factors. Methods: Forty children (age four to six years) scheduled for myringotomy were randomly assigned, in a double blind fashion, to receive either oral midazolam 0.5 mg·kg -1 mixed with acetaminophen suspension or acetaminophen alone. The Emotionality, Activity, Sociability, and Impulsivity (EASI) scale was used as a measure of child temperament. The modified Yale Preoperative Anxiety Scale (m-YPAS), an observer-rated measure of state anxiety, was employed to assess anxiety preand post-drug, and also at induction of anesthesia. Results: Children who received midazolam reacted significantly less to induction of anesthesia than did children in the placebo control group, F (1, 38) = 7.46, P = 0.01. A significant positive association was observed between baseline levels of anxiety and observer-rated anxiety at anesthetic induction, but only in the placebo group, r = 0.58, P < 0.01. A significant positive association was observed between levels of impulsivity at baseline and observer-rated anxiety at anesthetic induction, but only in the midazolam group, r = 0.42, P < 0.05. Conclusions: Midazolam dampened adverse reactivity during anesthetic induction, particularly among children with high baseline levels of anxiety. Baseline level of impulsivity was positively associated with adverse reactions to anesthesia induction in the drug group, but not in the placebo group, suggesting that high levels of trait impulsivity may contraindicate the use of midazolam as a preoperative medication. Objectif

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Section: Discussionmentioning

confidence: 66%

mentioning

confidence: 99%

High levels of impulsivity may contraindicate midazolam premedication in children

Finley¹,

Stewart²,

Buffett-Jerrott³

et al. 2006

Can J Anesth/J Can Anesth

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show abstract

“…This may be due to the lower dose of trimeprazine (2 mg.kg ¹1 ) used in our study compared with previous investigations which were carried out when the maximum recommended dose for this premedication was 4 mg.kg ¹1 [17]. Although four patients had sedation scores of 1 on discharge from recovery this resulted from them returning to sleep following recovery from anaesthesia and they were not further disturbed.…”

Section: Discussionmentioning

confidence: 67%

A comparison of midazolam with trimeprazine as an oral premedicant for children

et al. 1997

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SummaryThe effect of oral premedication was investigated in a double-blind, randomised trial in 85 children undergoing tonsillectomy and/or adenoidectomy. Orally administered midazolam 0.5 mg.kg ¹1 given 30 min pre-operatively was compared with trimeprazine 2 mg.kg ¹1 given 90 min pre-operatively and a placebo preparation. Compliance, sedation and ease of induction were assessed as were the duration and quality of recovery. Following premedication with midazolam none of the patients was anxious, crying or distressed on leaving the ward, compared with 2/28 in the trimeprazine group and 5/28 in the placebo group (p ¼ 0:0007). More patients were calm and quiet on arrival in the anaesthetic room following midazolam than following trimeprazine, with both premedicant agents comparing favourably with placebo. There was no significant difference between the three groups in the time to recovery or the sedation score on discharge to the ward. Midazolam is a safe and effective oral premedicant for children.

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“…Personality disorder is a contraindication for an elective surgical procedure 5 . It is necessary to conceptualize the predominant feelings to understand whether there is any contraindication or not for the surgical procedure 7,8,9 . Distress and fear may be mistaken.…”

Section: Discussionmentioning

confidence: 99%

“…These studies, more than once, demonstrated the need to have a comprehensive preoperative educational program bringing patients and physicians together. Teaching what patients do not know or are not familiar with prevent psychological sequels or worsening of underlying conditions 7,8,15,16 .…”

Section: Discussionmentioning

confidence: 99%

Perfil psicológico de crianças submetidas a adenoidectomia e/ou amigdalectomia no pré e pós-operatório

Fukuchi

Morato

Rodrigues

et al. 2005

Rev. Bras. Otorrinolaringol.

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Adenoi dectomy and/or tonsillectomy are the most frequent surgeries in otorhinolaryngology. Infantile psychological trauma may be caused by surgeries and anesthesia. Aim: To estimate the preoperative service offered to children and their responsible people by examining their psychological profile pre and postoperatively. Study Design: Clinical perspective. Material and Method: We have evaluated the medical chart of children between two and twelve years old who were submitted to adenoidectomy and/or tonsillectomy during February to December of 2003 and analyzed the psychological profile applied to the children and their responsible person. Results: Out of the total of 78 patients, 32 (41.0%) were in pre-school age and 46 (59.0%) in school age. The predominant feeling in pre-school age was fear (59.4%), while in school-aged children and their responsible guardian it was trust: 63.0% and 48.72%, respectively. As to expectation of surgery results, both children (73.08%) and their responsible people (96.15%) showed optimism. Introverted emotional temperament was observed in the majority of the children (52.56%) and their responsible people (51.28%). The emotional reaction at the immediate postoperative period of children and their guardians was calm: 68.18% and 97.73%, respectively. All children were psychologically apt to be submitted to the surgery. Conclusion: Independent of the predominant feeling or emotional temperament, good preoperative guidance is required. We have to offer preoperative teaching program that includes verbal descriptions of the procedures among the sensations to be experienced, allied with the interaction of children and parents, looking for reduction of anxiety, response to surgical stress and possible postoperative sequelae.

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Temazepam and Trimeprazine Compared With Placebo as Premedication in Children

Cited by 36 publications

References 17 publications

High levels of impulsivity may contraindicate midazolam premedication in children

High levels of impulsivity may contraindicate midazolam premedication in children

A comparison of midazolam with trimeprazine as an oral premedicant for children

Perfil psicológico de crianças submetidas a adenoidectomia e/ou amigdalectomia no pré e pós-operatório

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