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  • Title: [Oral and rectal premedication of children with midazolam]].
    Author: Pohl B, Schmicker F, Hofmockel R.
    Journal: Anaesthesiol Reanim; 2002; 27(3):60-7. PubMed ID: 12145915.
    Abstract:
    Premedication in children continues to be a problem in anaesthesiology. Apart from the application of premedication drugs, a strongly committed anaesthetist and sound psychological work are decisive prerequisites for adequate premedication. In this randomized study, 329 children aged between 1 and 14 who were scheduled for small surgical procedures were examined. Based on the results of a preliminary trial using different dosages of midazolam, the children were premedicated either orally with 0.4 mg/kg BW midazolam or with 0.3 mg/kg BW midazolam as a rectal solution and the premedication effect was recorded according to the classification of Lindgren. These reduced doses of midazolam, which were much lower than those described in the literature, led to very good premedication effects, too. Regarding cardiovascular behaviour, an increasing anxiolysis and the effect of premedication led to a significant decline in mean arterial blood pressure and heart frequency. The circulatory changes that occurred were at no time clinically relevant in any child, and therefore no treatment was needed. Based on the measured oxygen saturation, no significant respiratory changes were seen during the observation period. The frequency and extent of the registered side-effects were classified as slight. Side-effects such as singultus, salivation and ataxia/gesticulations were of no danger during the entire perioperative period.
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