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Rectal administration of midazolam versus diazepam for preanesthetic sedation in children

R Holm-Knudsen1, T G Clausen, D Enø

  • 1Department of Anesthesia, Gentofte Hospital, University of Copenhagen.

Anesthesia Progress
|January 1, 1990
PubMed

Insights

Rectal midazolam (0.4 mg/kg) and diazepam (0.75 mg/kg) offer comparable preanesthetic sedation in children. Both medications demonstrated similar efficacy and safety profiles in this pediatric trial.

Area of Science:

  • Anesthesiology
  • Pediatric Pharmacology

Background:

  • Preanesthetic sedation is crucial for managing pediatric anxiety and facilitating anesthesia induction.
  • Midazolam and diazepam are commonly used sedatives, but their comparative efficacy via rectal administration in children requires further investigation.

Purpose of the Study:

  • To compare the efficacy and safety of rectally administered midazolam versus diazepam for preanesthetic sedation in children.
  • To evaluate the degree of sedation achieved by both agents at different time points during the perioperative period.

Main Methods:

  • A double-blind, randomized trial involving sixty children.
  • Rectal administration of midazolam (0.4 mg/kg) or diazepam (0.75 mg/kg).
  • Assessment of sedation levels upon arrival in the operating unit and during anesthesia induction.

Main Results:

  • Adequate sedation was achieved in 84% of children with midazolam and 80% with diazepam upon arrival.
  • Sedation success rates during anesthesia induction were 67% for midazolam and 70% for diazepam.
  • No significant side effects were reported for either medication.

Conclusions:

  • Rectally administered midazolam at 0.4 mg/kg is comparable to diazepam at 0.75 mg/kg for preanesthetic sedation in pediatric patients.
  • Both agents appear to be safe and effective options for sedating children prior to anesthesia.

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