[Significant CO2 retention in children after premedication with Dormicum and Thalamonal]

Whereas in adults the use of Innovar for premedication has been abolished, the combination of midazolam and Innovar is still recommended for the premedication of children. This combination may lead to an additional depressive effect on respiration. A prospective, randomized study was performed to evaluate the risk of ventilatory depression. In 36 infants capillary blood gas values were measured pre- and postmedication with either rectal midazolam (0.4 mg/kg) and i.m. Innovar (0.04 ml/kg) or after oral chlorprothixene (2.0 mg/kg). After chlorprothixen the blood gas values did not change, whereas after the combination of midazolam and Innovar pCO2 rose significantly from 35.5 to 43.0 mmHg. In 7 of 22 cases pCO2 reached values above 45 mmHg. This difference compared to the chlorprothixene group was significant (p less than 0.05). The pH fell significantly from 7.42 to 7.36 in the combination group. Clinical signs of respiratory depression could not be observed in this group. The combination of midazolam with Innovar is therefore not useful for premedication in infants and young children.