[Intranasal midazolam for sedation before anesthesia in pediatric patients]

To evaluate the efficacy of nasally administered midazolam for sedation before anesthesia in pediatric patients, the authors studied 45 ASA PS 1 or 2 patients (aged 9 months-6 years) scheduled for elective surgery. The sedative effect of intranasal midazolam (0.2 mg.kg-1 or 0.3 mg.kg-1) was compared with that of our standard premedication by score. Significant sedative effect was obtained 4 min (in the 0.2 mg.kg-1 group) and 3 min (in the 0.3 mg.kg-1 group) after nasal administration. Most patients (93%) in the midazolam group became either free from anxiety or calm allowing easy separation from the parents and a smooth induction of anesthesia 10 min after nasal administration. There was no respiratory depression or anesthetic complication during induction of anesthesia, and no delayed recovery was observed. These results indicate that intranasal midazolam 0.2 mg.kg-1 is an effective and useful method for rapid sedation of children just prior to the induction of anesthesia.