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[The amnesic effects of midazolam in premedication of children]
1Département d'Anesthésie-Réanimation, Centre hospitalier Lyon-Sud, Pierre-Bénite.
Insights
Midazolam intramuscular administration demonstrated excellent anterograde amnesia in pediatric patients, with good local and general tolerance. Anxiolytic effects were inconclusive due to the short time interval.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Clinical Medicine
Background:
- Premedication in pediatric patients is crucial for managing anxiety and improving tolerance to procedures.
- Midazolam is a commonly used sedative and anxiolytic agent.
- Evaluating the safety and efficacy of intramuscular midazolam in children is important for clinical practice.
Purpose of the Study:
- To assess the local and general tolerance of intramuscular midazolam.
- To evaluate the anxiolytic and amnesic effects of midazolam as a pediatric premedication.
- To compare midazolam with a placebo in a double-blind study.
Main Methods:
- A double-blind, placebo-controlled study was conducted on 40 children aged 4-10 years.
- Participants were divided into two equal groups, receiving either midazolam or placebo intramuscularly.
- The dosage was 0.3-0.5 mg/kg of midazolam or placebo, combined with atropine sulfate (0.015 mg/kg).
Main Results:
- Midazolam showed good local and general tolerance in pediatric patients.
- Excellent anterograde amnesia was observed, with 17/20 children in the midazolam group not recalling a post-premedication photograph, versus 1/20 in the placebo group.
- Anxiolytic effects were similar in both groups and could not be definitively assessed due to the short interval.
Conclusions:
- Intramuscular midazolam is well-tolerated and effective in inducing anterograde amnesia in children.
- Further studies are needed to evaluate the anxiolytic effects with a longer observation period.
- Midazolam can be considered a viable option for pediatric premedication when amnesia is a primary goal.
Abstract:
The aim of this study was to check local and general tolerance as well as anxiolytic and amnesic effects of midazolam intramuscular administration as a premedication in 4 to 10 years old children. A double blind, comparative study with a placebo was achieved, after drawing lots, in 40 children divided into two equal groups. Premedication consisted of either midazolam or injectable water administrated with a posology of 0.3 to 0.5 mg.kg-1 combined, in both cases, with atropine sulfate (0.015 mg.kg-1). Results confirmed good local and general tolerance. Also anterograde amnesia was found to be excellent: 17 children in the midazolam group did not remember a photograph shown after premedication, instead of only one in the placebo group. Anxiolytic effects, similar in both groups, cannot be considered owing to the too short interval of time from premedication to induction.