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Rectal benzodiazepines for premedication in children. Review and personal experience

M J Govaerts1, V Capouet

  • 1Clinique d'Anesthésie Pédiatrique, Hôpital Universitaire des Enfants Reine Fabiola, Brussels.

Acta Anaesthesiologica Belgica
|January 1, 1987
PubMed

Insights

Pediatric premedication aims to reduce anxiety and ease induction. Rectal benzodiazepines, like diazepam or flunitrazepam, offer a less traumatic and more effective alternative to injections for anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Pharmacology

Background:

  • Modern anesthesia focuses on anxiolysis, amnesia, and smooth induction in pediatric patients.
  • Premedication strategies are crucial for achieving these goals.

Purpose of the Study:

  • To review current literature and author experience on pediatric premedication.
  • To evaluate the efficacy and administration routes of benzodiazepines for pediatric anesthesia.

Main Methods:

  • Literature review of pediatric premedication strategies.
  • Analysis of personal clinical experience with benzodiazepine administration.
  • Comparison of rectal versus intramuscular routes for benzodiazepine delivery.

Main Results:

  • Rectal benzodiazepine solutions are preferred over suppositories for faster, more predictable effects and reduced patient trauma.
  • Diazepam and flunitrazepam are commonly used, with flunitrazepam often favored due to its shorter elimination half-life.
  • Midazolam offers rapid onset and short duration, ideal for timely administration before induction.

Conclusions:

  • Rectal benzodiazepine administration is an effective and well-tolerated method for pediatric premedication.
  • Drug selection (diazepam, flunitrazepam, midazolam) depends on desired onset, duration, and administration timing.
  • Optimizing premedication enhances the pediatric anesthetic experience.

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