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Rectal flunitrazepam as premedication in preschool children. A double-blind randomized study
C Estève1, I Murat, C Saint-Maurice
1Department of Paediatric Anaesthesia, Hopital Saint Vincent de Paul, Paris, France.
Insights
Rectal flunitrazepam (0.04 mg.kg-1) effectively sedated young children before anesthesia. This low-dose premedication improved mask acceptance and induction, with no adverse events observed, making it a safe option.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Preoperative Medicine
Background:
- Premedication in pediatric anesthesia aims to reduce anxiety and facilitate induction.
- Rectal administration offers a non-invasive route for young children.
- Flunitrazepam is a benzodiazepine with sedative properties.
Purpose of the Study:
- To evaluate the efficacy and safety of low-dose rectal flunitrazepam as a premedicant in children under 5 years.
- To compare flunitrazepam premedication with placebo for inhalational induction.
Main Methods:
- Double-blind, placebo-controlled study involving 40 children under 5 years.
- Rectal flunitrazepam (0.04 mg.kg-1) administered 15 minutes before halothane mask induction.
- Assessment of sedation, mask acceptance, and induction scores.
Main Results:
- Significantly better sedation, mask acceptance, and induction scores in the flunitrazepam group.
- No hypoxic episodes or prolonged sedation were reported in either group.
- Rectal flunitrazepam demonstrated a favorable safety profile.
Conclusions:
- Low-dose rectal flunitrazepam is an effective and acceptable premedicant for young children.
- It improves the process of inhalational anesthesia induction.
- This method offers a safe and well-tolerated alternative for pediatric premedication.
Abstract:
The efficacy of flunitrazepam (0.04 mg.kg-1) as a premedicant was evaluated in 40 young children of less than 5 years of age in a double-blind, placebo-controlled study. Flunitrazepam was given by the rectal route 15 min prior to an inhalational mask induction with halothane. Sedation score, mask acceptance and induction score were significantly better in premedicated children than in the placebo group. There were no hypoxic episodes, prolonged sedation or other complications in either group. This suggests that flunitrazepam administered rectally in a low dose is an acceptable premedication in young children.
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