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

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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.