Lina Kalibatienė, Andrius Macas, Darius Trepenaitis, Ričardas Kubilius
The most common problem in children anaesthesiology is preoperative anxiety resulting in poor co-operation with medical staff in the operating room and postoperative behaviour disorders. Midazolam has become the most frequently used premedication in children, but not all forms of the administration are equally acceptable by children. The aim: to compare the sedative effects of midazolam tablets and liquid form on children‘s behaviour. Methodology: 90 patients, undergoing maxillofacial surgery operation with aneasthesia, ageing from 2 to 9 years, were involved in a prospective, randomized, controlled trial. Patients, whose parents agreed for the child sedation before operation, were allocated randomly to one of two groups: 1) Group of tablets, to whom sedation was performed by the administration of the midazolam tablet, 0.2 mg/kg dose, n=30; 2) Group of liquid form, to whom sedation was performed by the administration of the liquid form of midazolam, specially prepared from intravenous midazolam for use per os, 0.2 mg/kg dose, n=30. The third, or the control group, consisted from those patients, whose parents refused the sedation before maxillofacial surgery operation, but agreed to participate in the study, n=30. The behaviour of the patients was evaluated by the medical staff and parents. Results: there were no statistically significant differences comparing the behaviour of the patients of both groups of patients, who got the sedation, at the moment of separation from parents before surgery operation and the collaboration with the medical staff in the operation theater. In both groups of patients, who got the sedation, there were decreasing proportions of anxious and stressful, and statistically significant increase of the proportion of sleepy patients after use of the sedative medicines. Parents of the patients, who got midazolam tablets, evaluated the convenience of the form of sedative medicines as bad statistically significantly more often comparing with the parents of the patients, who got the liquid form of midazolam. 76.67% of the parents, whose children got the midazolam tablets, and 73.33% of the parents, whose children got the liquid form of midazolam, would ask for sedation once more if there were a need for surgical operation for their child. 90% of parents in group of tablets and 93.33% of parents in group of liquid form evaluated the satisfaction of the sedation as “very high” and “high”. Conclusions: there were no statistically significant differences on children’s behaviour comparing the use of midazolam tablets and liquid form. Statistically significantly more parents evaluated the convenience of the form of tablets as bad and very bad comparing with the liquid form of midazolam.
Keyword(s): sedation, children, midazolam tablets, liquid form of midazolam, parental satisfaction
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