Efficacy of midazolam as oral premedication in children in comparison to triclofos sodium

Kolathu Parambil Radhika, Melveetil S Sreejit, Konnanath T Ramadas, Kolathu Parambil Radhika, Melveetil S Sreejit, Konnanath T Ramadas

Abstract

Background and aims: The perioperative behavioural studies demonstrate that children are at greater risk of experiencing turbulent anaesthetic induction and adverse behavioural sequelae. We aimed to compare the efficacy of midazolam 0.5 mg/kg with triclofos sodium 100 mg/kg as oral premedication in children undergoing elective surgery.

Methods: In this prospective, randomised and double-blind study, sixty children posted for elective lower abdominal surgery were enrolled. The patients were randomly divided into midazolam group (Group M) and triclofos sodium group (Group T) of thirty each. Group M received oral midazolam 0.5 mg/kg 30 min before induction, and Group T received oral triclofos sodium 100 mg/kg 60 min before induction. All children were evaluated for level of sedation after premedication, behaviour at the time of separation from parents and at the time of mask placement for induction of anaesthesia. Mann-Whitney U-test was used for comparing the grade of sedation, ease of separation and acceptance of face mask.

Results: Oral midazolam produced adequate sedation in children after premedication in comparison to oral triclofos (P = 0.002). Both drugs produced successful separation from parents, and the children were very cooperative during induction. No adverse effects attributable to the premedicants were seen.

Conclusions: Oral midazolam is superior to triclofos sodium as a sedative anxiolytic in paediatric population.

Keywords: Anaesthesia; hypnotics and sedatives; midazolam; paediatrics; premedication; triclofos.

Figures

Figure 1
Figure 1
Level of sedation after premedication (assessed after 30 min in midazolam group and after 60 min in triclofos group) 1 = asleep not readily arousable, 2 = asleep responds slowly to gentle stimulation, 3 = drowsy readily responds, 4 = awake calm and quiet, 5 = awake active
Figure 2
Figure 2
Separation score (at the time of separation from parents) 1 = excellent-happily separated, 2 = good-separated without crying, 3 = fair-separated with crying, 4 = poor-need for restraint
Figure 3
Figure 3
Co-operation score (behavior during face mask placement at the time of induction) 1 = co-operative, 2 = mildly resistant, 3 = resists placement of mask

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Source: PubMed

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