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[Premedication in children: a comparison of oral midazolam and rectal bromazepam]
N Kambara1, S Kitamura, A Taniguchi
1Department of Anesthesiology, Osaka Children's Medical Center.
Insights
Midazolam syrup and bromazepam suppositories both effectively sedate children before anesthesia. Bromazepam offered better post-surgery sedation, while midazolam was superior for induction in children under four.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
Background:
- Preoperative sedation is crucial for pediatric surgical procedures.
- Evaluating the efficacy and safety of different sedatives in children is essential.
Purpose of the Study:
- To compare the sedative effects of midazolam syrup and bromazepam suppository in children undergoing minor surgery.
- To assess the impact on the circulatory system and the duration of sedation.
Main Methods:
- Seventy-seven children undergoing minor surgery (<90 minutes) were randomized into two groups.
- One group received midazolam syrup, the other received bromazepam suppository.
- Sedative effects were evaluated before, during, and after anesthesia, along with circulatory system effects.
Main Results:
- Both midazolam syrup and bromazepam suppository showed comparable sedative effects before/during anesthesia induction.
- Bromazepam suppository demonstrated significantly better sedation 1-2 hours post-surgery.
- Midazolam syrup was more effective for intra-induction sedation in children under 4 years old.
Conclusions:
- Midazolam syrup and bromazepam suppositories are effective for preoperative sedation in pediatric surgery.
- Bromazepam offers prolonged sedation post-operatively, while midazolam is preferred for induction in younger children (<4 years).
- Further research may explore optimal dosing and combinations for enhanced pediatric sedation protocols.
Abstract:
Seventy-seven children for minor surgery of less than 90 minutes in duration were divided into two groups; one group received midazolam syrup and the other received bromazepam suppository. The sedative effect before or after the induction of the anesthetic, the effect on the circulatory system, and the prolongation of the sedative effect after surgery were studied. Regarding the sedative effect before or during the induction of anesthesia, both medications were effective with no significant difference between the two groups. However, the bromazepam suppository had a significantly better sedative effect 1 or 2 hours after the surgery. In children under 4 years of age, the sedative effect during the induction was obtained by administering midazolam syrup before the surgery. It is indicated that midazolam syrup is superior to the bromazepam suppository in children under 4 years of age.