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[Midazolam for anesthetic induction in neonates]
K Kawakami1, J Ohata, M Kadosaki
1Department of Anesthesiology, Nagano Children's Hospital.
Masui. the Japanese Journal of Anesthesiology
|June 11, 1998
Summary
Midazolam combined with lidocaine offers effective anesthetic induction in neonates, with careful monitoring for potential side effects like hypotension and apnea. This combination aids sedation during neonatal surgery.
Area of Science:
- Neonatal Anesthesia
- Pediatric Pharmacology
Background:
- Neonatal surgical procedures require careful anesthetic management.
- Sedation and intubation in neonates present unique physiological challenges.
Purpose of the Study:
- To evaluate the effects of midazolam combined with lidocaine on neonatal circulation, respiration, sedation, and liver function.
- To compare the incidence of adverse events between lidocaine alone and midazolam with lidocaine in neonates undergoing surgery.
Main Methods:
- A comparative study involving 27 neonates undergoing surgery.
- Group L (n=13) received lidocaine (1.5 mg/kg) before intubation.
- Group ML (n=14) received midazolam (0.1 mg/kg) with lidocaine before intubation.
Main Results:
- Hypotension and desaturation occurred in one patient in Group L.
- Desaturation and post-operative apnea occurred in one patient in Group ML.
- Midazolam with lidocaine significantly increased sedation compared to lidocaine alone; no significant impact on liver function (bilirubin levels) was observed.
Conclusions:
- Titrated midazolam with lidocaine is a useful option for anesthetic induction in neonates.
- Adverse effects such as hypotension, desaturation, and post-operative apnea require careful consideration and monitoring.
- This combination demonstrates efficacy in neonatal sedation without adverse effects on liver function.