• Y-C P Arai, K Fukunaga, and S Hirota.
• Department of Anesthesiology, Kochi Medical School, Oko-Cho, Nankoku City, Kochi 783-8505, Japan. arainon@med.kochi-ms.ac.jp
• Acta Anaesthesiol Scand. 2005 May 1;49(5):698-701.

BackgroundPreanesthetic anxiety and emergence agitation are major challenges for anesthesiologists in pediatric anesthesia. Thus, midazolam has been used as premedication for children. However, midazolam alone is not effective for emergence agitation. The present study tested the effect of a combination of midazolam and diazepam on the preanesthetic condition and emergence behavior in children.MethodsForty-two children were allocated to one of three groups: the NoPre group received no premedication; the Mi group received midazolam 0.5 mg kg(-1) orally; and the Mi + Di group received midazolam 0.25 mg kg(-1) and diazepam 0.25 mg kg(-1) orally. When anesthesia was induced with 7% sevoflurane in 100% oxygen, qualities of mask induction and sedation were rated. Anesthesia was maintained with sevoflurane (3-5%) in 100% oxygen. During emergence from anesthesia, the score of the child's emergence behavior was rated.ResultsChildren in the Mi and Mi + Di groups were more sedated than those in the NoPre group. A combination of midazolam and diazepam provided a better quality of mask induction, when compared with no premedication. Also, the children in the Mi + Di group were less agitated than those in the other groups during the emergence.ConclusionChildren in the Mi + Di group were significantly more sedated at induction of anesthesia and less agitated during emergence from anesthesia.

This article appears in the collection: Is pre-medication useful in pediatric anesthesia?.

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