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Oral administration of midazolam as a premedicant for paediatric day-case anaesthesia

A McCluskey1, G H Meakin

  • 1University Department of Anaesthesia, Royal Manchester Children's Hospital, Pendlebury.

Anaesthesia
|September 1, 1994
PubMed

Insights

Oral midazolam effectively reduced preoperative anxiety in children undergoing anesthesia. While it slightly prolonged recovery, it also decreased postoperative behavioral issues, improving the overall patient experience.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology

Background:

  • Preoperative anxiety is common in pediatric patients undergoing anesthesia.
  • Effective anxiolysis is crucial for a positive perioperative experience.

Purpose of the Study:

  • To evaluate the efficacy of oral midazolam for preoperative anxiolysis in children.
  • To assess the impact of midazolam on anxiety, recovery, and postoperative behavior.

Main Methods:

  • Double-blind, placebo-controlled study involving 54 children (aged 1-10 years).
  • Administration of oral midazolam (0.5 mg.kg-1) or placebo 30-60 minutes preoperatively.
  • Assessment of anxiolysis, recovery time, hospital discharge time, and postoperative behavioral disturbances via questionnaires.

Main Results:

  • Midazolam significantly improved anxiolysis at induction room (96% vs 44%) and anesthesia induction (88% vs 33%).
  • Midazolam group experienced longer early recovery (28.2 vs 21.9 min) and hospital discharge times (244 vs 185 min).
  • Fewer postoperative behavioral disturbances were reported in the midazolam group (p < 0.05).

Conclusions:

  • Oral midazolam is an effective anxiolytic agent for pediatric day-case anesthesia.
  • While associated with slightly prolonged recovery, midazolam reduces postoperative behavioral disturbances.
  • Midazolam offers a favorable risk-benefit profile for pediatric preoperative sedation.

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