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[Oral premedication with midazolam in children]
G Molter1, P Altmayer, G Castor
1Klinik für Anästhesiologie und Intensivmedizin, Universitätskliniken des Saarlandes.
Anaesthesiologie Und Reanimation
|January 1, 1991
Summary
Oral midazolam is a safe and effective premedication for pediatric surgery, offering mild sedation and positive behavioral outcomes. This method is preferred over intramuscular or rectal administration for children undergoing elective procedures.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Context:
- Preoperative anxiety and distress are common in pediatric patients undergoing surgery.
- Traditional premedication methods like intramuscular injections can be painful and traumatic.
- Alternative, less invasive premedication strategies are needed to improve the pediatric surgical experience.
Purpose:
- To evaluate the efficacy and safety of oral midazolam as a premedication in children undergoing elective urological surgery.
- To assess the sedative, behavioral, and emotional effects of oral midazolam in pediatric patients.
- To compare the physiological and side effect profiles of oral midazolam premedication.
Summary:
- A study involving 100 children (6 months-10 years) found oral midazolam (0.4 mg/kg) resulted in mild to no preoperative sedation in 76-84% of patients.
- Preoperative behavior was cooperative or passive in 67-88%, with 70-84% exhibiting indifferent or euphoric states.
- Postoperatively, significant sedation was observed (57-89%), with minimal alterations in circulatory parameters and rare side effects (hiccough, vomiting, laryngospasm, stridor).
Impact:
- Oral midazolam provides a favorable alternative to intramuscular or rectal premedication, reducing patient distress.
- This approach can lead to a more positive preoperative experience for children and their families.
- The findings support the recommendation of oral midazolam for routine premedication in pediatric surgical patients.