Efficacy of Different Doses of Oral Midazolam for Pre Operation Sedation of Children

Background One of the major problems in pediatric surgery is anxiety and fear of separation from parents. Objectives We studied the efficacy of different doses of oral midazolam for pre operation sedation of children. Patients and Methods In this randomized, double-blinded clinical trial, 120 children aged 1 - 8 years were enrolled in the study .The children were randomly assigned to one of 4 groups and received orally 0.5 mg/kg (group A), 0.8 mg/kg (group B), 1 mg/kg (group C), 0mg/kg (group D) of injectable midazolam mixed with 10 - 15 mL apple juice 45 minutes before separation from parents. Sedation score, changes in MAP, HR, SPO2, respiratory rate, time of recovery and frequency of nightmares evaluated and analyzed with Kruskal-Wallis and ANOVA tests. Results The mean age of children was 4.46 ± 2.17 years. Sedation levels in 26 patients in group A and 21 patients in group C were desirable qualified. MAP changes increased in group D and decreased in the other groups. Most changes were observed in group C equals -3 ± 2.5 mmHg. Most changes in heart rate were observed in group D (increased to 11.5 ± 7.41 beat). Most decrease of SPO2 was in group A (-0.86 ± 0.93%). Maximum decrease of RR was in group C (-3.36 ± 2.88%). Maximum of recovery time was observed in group C (76.3 ± 12.67 minutes). Group D had the highest frequency of nightmares (10 children, 58.8%). Conclusions Oral midazolam with 0.8 mg/kg, as premedication, reduces recovery time and hemodynamic disturbances .We can use that as appropriate premedication dose in children for reducing children anxiety and fear of separation from parents.