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Oral midazolam premedication and postoperative behaviour in children
1Oregon Health Sciences University, Portland 97201, USA.
Paediatric Anaesthesia
|April 29, 1998
Summary
Oral midazolam premedication in children reduced crying during anesthesia induction. However, it was associated with a higher incidence of adverse postoperative behavioral changes, such as nightmares and anxiety, one week later.
Area of Science:
- Pediatric Anesthesiology
- Behavioral Pediatrics
Background:
- Preoperative anxiety and behavioral distress are common in children undergoing anesthesia.
- Sedative premedication aims to alleviate these issues, but its long-term effects require careful evaluation.
Purpose of the Study:
- To investigate the impact of oral midazolam premedication on children's behavior during anesthesia induction and in the postoperative period.
- To assess the incidence of adverse behavioral changes following midazolam administration.
Main Methods:
- A prospective, randomized, blinded study involving 70 children (ASA Physical Status 1 and 2; aged 1-10 years).
- Participants received either oral midazolam (0.5 mg/kg, max 10 mg) or placebo.
- Behavioral assessments were conducted before medication, during induction, and 15 minutes post-recovery.
Main Results:
- Children receiving midazolam exhibited significantly less crying during anesthesia induction (P < 0.02).
- One week post-procedure, 19 of 35 children in the midazolam group reported adverse behavioral changes (e.g., nightmares, anxiety), compared to 8 of 35 in the placebo group (P < 0.02).
- Most behavioral changes resolved by four weeks post-procedure.
Conclusions:
- Oral midazolam effectively reduces crying and distress during anesthesia induction in pediatric patients.
- Preoperative midazolam is associated with an increased incidence of adverse postoperative behavioral changes, necessitating careful consideration of risks and benefits.
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