The effects of midazolam oral solution on preoperative sedation, hemodynamics, and awakening agitation in children undergoing tonsillectomy combined with adenoidectomy
10.3760/cma.j.cn431274-20230511-00674
- VernacularTitle:咪达唑仑口服溶液对扁桃体联合腺样体切除术患儿术前镇静、血流动力学及苏醒期躁动的影响
- Author:
Dan DAI
1
;
Tingting LIU
;
Jing GAO
Author Information
1. 浙江大学医学院附属儿童医院麻醉科，杭州 311200
- Keywords:
Midazolam;
Adenoidectomy;
Tonsillectomy;
Sedation
- From:
Journal of Chinese Physician
2024;26(4):514-518
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of midazolam oral solution on preoperative sedation, hemodynamics, and awakening agitation in children undergoing tonsillectomy combined with adenoidectomy.Methods:A total of 267 pediatric patients who underwent tonsillectomy combined with adenoidectomy at the Children′s Hospital Affiliated to Zhejiang University School of Medicine from January to September 2022 were randomly divided into a low-dose group ( n=89), a high-dose group ( n=89), and a control group ( n=89) using a random number table method. 30 minutes before anesthesia, the low-dose group received 0.25 mg/kg of midazolam orally, the high-dose group received 0.5 mg/kg of midazolam orally, and the control group received 5 ml of 10% glucose mixture orally. We compared the extubation time and post anesthesia recovery room (PACU) retention time among three groups of pediatric patients; Mean arterial pressure (MAP) and heart rate (HR) levels before administration and 10, 20, and 30 minutes after administration; The Yale Modified Perioperative Anxiety Scale (mYPAS) score and restlessness incidence were measured before administration and 10 and 60 minutes after administration. Results:The retention time of PACU in the low-dose group was shorter than that in the high-dose group ( P<0.05), and there was no statistically significant difference between the low-dose group and the control group ( P>0.05). At 10, 20, and 30 minutes after administration, the levels of MAP and HR in the low-dose and high-dose groups were lower than before administration (all P<0.05), and at 10, 20, and 30 minutes after administration, the levels of MAP and HR in the low-dose and high-dose groups were lower than those in the control group (all P<0.05). Before administration, there was no statistically significant difference in mYPAS scores among the three groups (all P>0.05); At 10 and 60 minutes after administration, the mYPAS scores of the low-dose and high-dose groups were lower than before administration, and the mYPAS scores of the low-dose and high-dose groups were lower than those of the control group (all P<0.05); At 10 and 60 minutes after administration, there was no statistically significant difference in mYPAS scores between the control group and before administration (all P>0.05), while there was no statistically significant difference in mYPAS scores between the low-dose and high-dose groups (all P>0.05). There was no statistically significant difference in the incidence of agitation among the three groups ( P>0.05). Conclusions:Preoperative oral administration of 0.25 mg/kg or 0.5 mg/kg midazolam can effectively alleviate preoperative anxiety and improve hemodynamics in children undergoing tonsillectomy combined with adenoidectomy. However, due to the fast metabolism of midazolam, its effect on improving postoperative restlessness during the recovery period is not significant. The 0.25 mg/kg dose of midazolam can reduce the retention time of PACU compared to the 0.5 mg/kg dose, which is worthy of clinical recommendation.
