Comparison Of Three Different Doses Of Oral Midazolam For Preanaesthetic Medication In Paediatric Patients
Journal Title: National Journal of Medical and Dental Research - Year 2017, Vol 5, Issue 2
Abstract
Background and Aims: Preoperative anxiety is shown to be associated with release of stress hormones that affect the haemodynamics of the patients intra-operatively and postoperatively. An effective premedication facilitates smooth induction of general anaesthesia with reduced hemodynamic disturbances. Elevated anxiety causes psychological problems in children. Midazolam has been demonstrated to be a very good sedative, anxiolytic and amnesic premedicant. This study was aimed to make use of the readily available intravenous Midazolam as a substitute for oral Midazolam in three different doses to assess ease of separation from parents, co-operation for venepuncture, preoperative and post operative sedation score. Settings and Design: A prospective, double blind, randomized study Material and Method: 90 paediatric patients of 2-8 years of age undergoing different types of surgeries under general anaesthesia were randomly divided into three groups of 30 each. Preoperatively they received Midazolam 0.5mg/kg, 0.75mg/kg and 1.0mg/kg body weight, commercially available intravenous preparation for oral administration. It was diluted in apple juice and given 40 minutes prior to the induction of anaesthesia Ease of separation from parents, level of sedation ,cooperation of patient for venepuncture were recorded. Result: Mean heart rate, blood pressure, respiratory rate and SpO2 in Group A, Group B and Group C were statistically comparable(p value=0.170, p value = 0.063, p value = 0.73 respectively). After 40 minutes of oral Midazolam; in Group A, 53.33% were comfortable; whereas in Group B, 90% were comfortable and in Group C, all the patients were comfortable. Sedation score was more in Group C than in Group B than in Group A. In Group A, only 26.67% patients had good cooperation; whereas in Group B, 56.67% had good and 20% had excellent co-operation. In Group C, 70% patients had excellent cooperation for venepuncture. Conclusion: 0.75 mg/kg and 1 mg/kg body weight dose provided better results than 0.5mg/kg in terms of ease of separation from parents and co-operation for venepuncture. 1 mg/kg body weight dose did not provide any added benefit over the 0.75 mg/kg. The patients receiving 1 mg/kg dose were more sedated while being taken into the operation theatre.
Authors and Affiliations
Mohod Vaishali, Samal Samir
Keywords
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