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Midazolam premedication in paediatric anaesthesia.

K A Payne, J J Heydenrych, T C Kruger

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde

|November 22, 1986

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Midazolam is an effective pediatric premedication, improving pre-anesthesia behavior without delaying recovery. This study compared midazolam, TDM, and no sedation in children, finding midazolam superior for managing anxiety.

Area of Science:

Pediatric Anesthesiology
Pharmacology

Background:

Premedication in pediatric anesthesia is crucial for managing anxiety and ensuring smooth induction.
Traditional sedative agents may have drawbacks, necessitating evaluation of alternatives.

Purpose of the Study:

To evaluate the efficacy of midazolam as a pediatric premedication compared to a combination of trimeprazine, droperidol, and methadone (TDM) and no sedation.

Main Methods:

A randomized controlled trial involving 150 children aged 6 months to 5 years.
Three groups received midazolam, TDM, or no sedative medication, respectively.
Behavioral assessments were conducted in the holding room and during induction, with recovery times and temperature monitoring.

Main Results:

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Midazolam demonstrated superior behavioral patterns in the holding room compared to TDM and no sedation.

Induction behavior was comparable across all groups.

Recovery times were similar for midazolam and the unsedated group, but significantly prolonged in the TDM group.

Body temperatures remained stable with midazolam and no sedation, but decreased with TDM.

Conclusions:

Midazolam is a satisfactory premedication agent for pediatric patients, offering benefits in pre-anesthetic behavior without adverse effects on recovery or temperature.
The TDM combination resulted in delayed recovery and hypothermia, suggesting it is less suitable for pediatric premedication.