The effects of midazolam administered postoperatively on emergence agitation in pediatric strabismus surgery
- PMID: 20498811
- PMCID: PMC2872899
- DOI: 10.4097/kjae.2010.58.1.45
The effects of midazolam administered postoperatively on emergence agitation in pediatric strabismus surgery
Abstract
Background: The present study tested the effect of midazolam administration after sevoflurane anesthesia against emergence agitation in children in the recovery phase.
Methods: A total of 60 children presenting for ophthalmic surgery under sevoflurane anesthesia were randomly placed in four groups from Group I to Group IV. Before the end of the surgery, we injected normal saline 2 ml in Group I and Group IV. We administered a 2-ml mixture of midazolam 0.025 mg/kg and midazolam 0.050 mg/kg to Group II and Group III respectively. Among the patients with agitation scores 4 or 5 in the peostanesthesia care unit (PACU), Group IV patients were intravenously given a 1-ml mixture of midazolam 0.025 mg/kg and normal saline up to 3 times. Agitation parameters, anesthesia recovery times, and the total administration amounts of midazolam were measured.
Results: Extubation time was significantly longer and maximum agitation scores higher in Group III than in Group I. The rate of the length of the period when the agitation score was 4 or 5 out of the length of stay in the PACU was significantly lower in Group II, Group III, and Group IV than in Group I. The length of stay in the PACU was significantly longer in Group III, and Group IV than in Group I.
Conclusions: For pediatric patients under sevoflurane anesthesia, postoperative midazolam administration slightly prolonged the length of stay in the PACU. But it effectively reduced emergence agitation without any side effects.
Keywords: Emergence agitation; Midazolam; Sevoflurane.
Similar articles
-
Effect of ancillary drugs on sevoflurane related emergence agitation in children undergoing ophthalmic surgery: a Bayesian network meta-analysis.BMC Anesthesiol. 2019 Aug 1;19(1):138. doi: 10.1186/s12871-019-0810-y. BMC Anesthesiol. 2019. PMID: 31370793 Free PMC article. Review.
-
The effect of midazolam administration for the prevention of emergence agitation in pediatric patients with extreme fear and non-cooperation undergoing dental treatment under sevoflurane anesthesia, a double-blind, randomized study.Drug Des Devel Ther. 2019 May 17;13:1729-1737. doi: 10.2147/DDDT.S198123. eCollection 2019. Drug Des Devel Ther. 2019. PMID: 31190751 Free PMC article. Clinical Trial.
-
Comparison of the effects of 0.03 and 0.05 mg/kg midazolam with placebo on prevention of emergence agitation in children having strabismus surgery.Anesthesiology. 2014 Jun;120(6):1354-61. doi: 10.1097/ALN.0000000000000181. Anesthesiology. 2014. PMID: 24566243 Clinical Trial.
-
Prophylactic midazolam and clonidine for emergence from agitation in children after emergence from sevoflurane anesthesia: a meta-analysis.Clin Ther. 2013 Oct;35(10):1622-31. doi: 10.1016/j.clinthera.2013.08.016. Epub 2013 Sep 25. Clin Ther. 2013. PMID: 24075150 Review.
-
Premedication with low-dose oral midazolam reduces the incidence and severity of emergence agitation in pediatric patients following sevoflurane anesthesia.Acta Anaesthesiol Sin. 2001 Dec;39(4):169-77. Acta Anaesthesiol Sin. 2001. PMID: 11840583 Clinical Trial.
Cited by
-
Effect of ancillary drugs on sevoflurane related emergence agitation in children undergoing ophthalmic surgery: a Bayesian network meta-analysis.BMC Anesthesiol. 2019 Aug 1;19(1):138. doi: 10.1186/s12871-019-0810-y. BMC Anesthesiol. 2019. PMID: 31370793 Free PMC article. Review.
-
Prevention of Emergence Delirium in Children - A Randomized Study Comparing Two Different Timings of Administration of Midazolam.Anesth Essays Res. 2018 Apr-Jun;12(2):522-527. doi: 10.4103/aer.AER_52_18. Anesth Essays Res. 2018. PMID: 29962628 Free PMC article.
-
Effects of sevoflurane versus other general anaesthesia on emergence agitation in children.Cochrane Database Syst Rev. 2014 Sep 12;2014(9):CD007084. doi: 10.1002/14651858.CD007084.pub2. Cochrane Database Syst Rev. 2014. PMID: 25212274 Free PMC article. Review.
-
Role of Benzodiazepines in the management of agitation due to inappropriate use of naltrexone.Iran J Nurs Midwifery Res. 2012 Jul;17(5):365-9. Iran J Nurs Midwifery Res. 2012. PMID: 23853649 Free PMC article.
-
The influence of DNA polymorphism of multidrug resistant 1 (MDR1) on the effect of midazolam pretreatment in children.Korean J Anesthesiol. 2012 Apr;62(4):332-6. doi: 10.4097/kjae.2012.62.4.332. Epub 2012 Apr 23. Korean J Anesthesiol. 2012. PMID: 22558499 Free PMC article.
References
-
- Cote CJ. Pediatric anesthesia. In: Miller RD, editor. Miller's anesthesia. 7th ed. Philadelphia: Churchill Livingstone; 2009. pp. 2565–2569.
-
- An TH. The comparison of incidence of postoperative agitation in children after enflurane or sevoflurane inhalation anesthesia. Korean J Anesthesiol. 2002;43:174–178.
-
- Everett LL. Anesthesia for children. In: Longnecker DE, Brown DL, Newman MF, Zapol WM, editors. Anesthesiology. New York: McGraw-Hill; 2008. p. 1533.
-
- Morgan GE, Mikhail MS, Murray MJ. Clinical anesthesiology. 4th ed. USA: McGraw-Hill; 2006. pp. 173–174.
-
- Johannesson GP, Florén M, Lindahl SG. Sevoflurane for ENT-surgery in children. A comparision with halothane. Acta Anaesthesiol Scand. 1995;39:546–550. - PubMed
LinkOut - more resources
Full Text Sources