Oral midazolam: Preanaesthetic medication in children, a dose finding study
Journal Title: MedPulse -International Medical Journal - Year 2014, Vol 1, Issue 10
Abstract
Background: Pediatric patients are always challenging in anaesthesia and surgery. Premedication and adequate sedation of children before they enter in Operation Theater is of significant importance for smooth induction and reducing the mental trauma of getting separated from parents. It will help in reducing sensory inputs, metabolic rate and will antagonize adverse reaction of autonomic nervous system. Methods: Randomly selected 104 patients from age group 3 years to 10 years posted for surgeries with ASA grade I and II were included in study. Exclusion criteria were babies on anticonvulsant, known allergic children, and babies having history of systemic diseases. All basic investigations were noted, the weight was noted and patients accepted only when the routine investigations were in within normal limits. Written valid informed consent was obtained from parents or legal guardians. Three groups were made. Group A) placebo and Atropine 0.03mg/kg, Group B) Midazolam 0.25 mg /kg and Atropine 0.03mg/kg, Group C) Midazolam 0.50mg/kg and Atropine 0.03mg/kg was given orally 30 min before the induction of anaesthesia. The study solution was prepared in 3ml of 25% Dextrose immediately prior to administration. The anaesthetic management was similar in all groups. The analysis of data was carried out by using Chi-square test, standard deviation. Results: The patient’s level of sedation, separation from parents, and quality of induction (mask acceptance) was statistically significant which was very good to excellent in group 3, and post operative behavior, time spent in recovery room and time of wakening was almost same in all groups. From this it was clear that the oral Midazolam in minimal dose of 0.50mg/kg is having very good anxiolysis in children at least 30 mins prior to induction of anaesthesia. Conclusions: We conclude that the oral premedication with Midazolam at a dose of 0.50 mg /kg at least 30 mins prior of induction provide excellent baby sedation and reduce the mental trauma of child of being get separated from parents and make ease of anaestheisa induction.
Authors and Affiliations
Rajgure Arvindanand Murlidhararo, Prabha Nayak, Sudhir Bhope
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