A comparative study on the efficacy of rectal diazepam and midazolam for reduction of pre-operative anxiety in pediatric patients

Objective: Children, due to their great parental dependency, are amongst the cases that shouldreceive preoperatively medication to reduce their fear and anxiety. The objective of this studywas to compare the efficacy of rectal diazepam and midazolam for this purpose in pediatricpatients scheduled for elective surgery.Material Methods: 60 children, aged between 1 and 6 years, scheduled for elective surgery,were included in this double blind, randomized controlled trial. Patients were randomly allocatedinto three equal groups. Patients in midazolam and diazepam groups received the drugs 0.3mg/kg and 0.5 mg/kg respectively (in normal saline at a final volume of 2.5 ml) and placebogroup received only 2.5 ml of normal saline 20 min before arriving operation room throughrectal applicator. Sedation and anxiety scores at the time of separation from their parents beforearriving operating room were recorded for all groups.Findings: There was a significant reduction in anxiety level in midazolam and diazepam groupsas compared to placebo group (P 0.001). Sedation rate was 65% for midazolam, 60% fordiazepam, and 15% for placebo group (P=0.007). There were no significant changes inhemodynamic parameters in the three study groups.Conclusion: With respect to effective anxiolytic and sedative activity, rectal midazolam (0.3mg/Kg) and diazepam (0.5 mg/Kg) can be used as an anesthetic premedicant for children at preoperative period and their use is safe regarding hemodynamic variables and related side-effects.