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Canadian Journal of Anesthesia, Vol 42, 473-478, Copyright © 1995 by Canadian Anesthesiologists' Society

ARTICLES

Premedication for ambulatory surgery in preschool children: a comparison of oral midazolam and rectal thiopentone

B Lyons, N Cregg, F Conway, W Casey, P Doherty and KP Moore
Department of Anaesthesia, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.

Seventy five ASA 1 and 2 children, aged between six months and five years were randomized to receive oral midazolam 0.5 mg.kg-1, rectal thiopentone 35 mg.kg-1 or no premedication to compare the safety and efficacy of, and parental attitudes to, both premedicants. Cardio-respiratory variables were from the time of premedication to awakening from anaesthesia. In addition, anxiety and sedation scores and patients' acceptance of both premedicant and mask at induction, were all recorded using four-point rating scales. Times to recovery and discharge, and parental satisfaction with the premedication their child had received were also recorded. Children receiving rectal thiopentone had higher sedation scores and were more accepting of the mask than were the other two groups (P < 0.001). Their acceptance of the premedication was similar to that of the midazolam group. Times to spontaneous eye opening and discharge were longer in the thiopentone group (P < 0.005). Parental preoperative satisfaction rating was higher for thiopentone, but not midazolam, than no premedication (P < 0.05). When asked their premedication preferences for subsequent general anaesthetics, a higher proportion of parents whose children were not premedicated requested an alternative regimen (P < 0.01). In conclusion the study found that premedication with rectal thiopentone provided superior induction characteristics to oral midazolam, but with a longer recovery period.


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R. G. Cox, U. Nemish, A. Ewen, and M.-J. Crowe
Evidence-based clinical update: Does premedication with oral midazolam lead to improved behavioural outcomes in children?: [Mise a jour basee sur des donnees probantes : Ameliore-t-on le comportement des enfants par une premedication au midazolam par la bouche ?]
Can J Anesth, December 1, 2006; 53(12): 1213 - 1219.
[Abstract] [Full Text] [PDF]


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Copyright © 1995 by the Canadian Anesthesiologists' Society.