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SHR Neuro Cancer Cardio Lipid Metab Microb
Breschan, C; Platzer, M; Jost, R; Stettner, H; Likar, R.
Midazolam does not reduce emergence delirium after sevoflurane anesthesia in children.
Paediatr Anaesth. 2007; 17(4): 347-52.
Doi: 10.1111/j.1460-9592.2006.02101.x
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Breschan Christian
- Co-authors Med Uni Graz
- Likar Rudolf
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- Abstract:
- BACKGROUND: Behavioral disturbance in children following sevoflurane anesthesia is a relatively frequent event. The aim of this study was to evaluate whether a higher dose of preoperatively administered rectal midazolam compared with a lower would alleviate this phenomenon. Furthermore the impact of these two doses of midazolam on sedation at induction of anesthesia was compared. METHODS: A total of 115 children presenting for minor surgery under anesthesia were included in the study. The children were randomized to receive rectally either 1 mg.kg(-1) midazolam (group H) or 0.5 mg.kg(-1) midazolam (group L). General anesthesia was induced with propofol or sevoflurane and maintained with 1.5% sevoflurane in the inspiratory limb. Prior to the start of surgery a regional block was performed to ensure adequate pain relief. Behavior on emergence was assessed using a three point scale. In case of severe agitation propofol was administered IV. RESULTS: The children in group H were significantly better sedated preoperatively (P < 0.01). There was no significant difference in emergence behavior: 42.1% of children in group H compared with 36.2% of children in group L exhibited severe agitation requiring sedation with propofol (P = 0.37). However, regardless of the preoperative dose of midazolam more children under the age of 36 months (61.4%) were severely distressed at emergence compared with older children (16.7%) (P < 0.01). CONCLUSIONS: A higher dose of 1 mg.kg(-1) rectal midazolam results in much better sedated children on induction of anesthesia than 0.5 mg.kg(-1). This, however, does not result in a reduced incidence of emergence delirium after sevoflurane anesthesia. Regardless of the premedication negative behavioral changes occur more frequently in children younger than 3 years of age.
- Find related publications in this database (using NLM MeSH Indexing)
- Administration, Rectal - administration & dosage
- Age Factors - administration & dosage
- Akathisia, Drug-Induced - drug therapy
- Anesthesia, General - methods
- Anesthetics, Inhalation - adverse effects
- Anesthetics, Intravenous - administration & dosage, therapeutic use
- Child, Preschool - administration & dosage
- Delirium - chemically induced, drug therapy, prevention & control
- Dose-Response Relationship, Drug - administration & dosage
- Female - administration & dosage
- Humans - administration & dosage
- Infant - administration & dosage
- Male - administration & dosage
- Methyl Ethers - adverse effects
- Midazolam - administration & dosage, therapeutic use
- Minor Surgical Procedures - methods
- Nerve Block - methods
- Postoperative Complications - chemically induced, drug therapy, prevention & control
- Propofol - administration & dosage
- Prospective Studies - administration & dosage
- Sevoflurane - administration & dosage
- Stress, Psychological - chemically induced, drug therapy
- Time Factors - administration & dosage
- Treatment Failure - administration & dosage
- Find related publications in this database (Keywords)
- emergence agitation
- children
- sevoflurane anesthesia