title: Sublingual midazolam premedication in children: a dose response study.
abstract: The purpose of this study was to evaluate various doses of sublingual midazolam premedication in children. In our prospective, double-blind, placebo-controlled trial, children (n = 102, age range 12 to 129 months) scheduled for day surgery were randomized to receive either midazolam in one of three doses (0.25, 0.5, or 0.75 mg.kg-1) or placebo. Injectable midazolam was mixed with a thick grape syrup and placed under the tongue; the patient was asked to hold it as long as possible before swallowing. Children readily accepted the mixture. Analysing all patients randomized, none of the children receiving placebo vs 28% receiving 0.25 mg.kg-1 (P = 0.02), 52% receiving 0.5 mg.kg-1 (P < 0.001), and 64% receiving 0.75 mg.kg-1 (P < 0.001) of midazolam showed satisfactory sedation (drowsy) at 15 min after administration. Children receiving the two higher doses of midazolam (0.5 and 0.75 mg.kg-1) accepted mask induction willingly, while the group receiving 0.25 mg.kg-1 resembled the placebo group (P < 0.05).
authors.affiliation: Department of Anaesthesiology, University of Texas Medical School, Houston, USA.
authors.forename: S
authors.initials: S
authors.lastname: Khalil
authors.forename: L
authors.initials: L
authors.lastname: Philbrook
authors.forename: M
authors.initials: M
authors.lastname: Rabb
authors.forename: K
authors.initials: K
authors.lastname: Wagner
authors.forename: C
authors.initials: C
authors.lastname: Jennings
authors.forename: A Z
authors.initials: AZ
authors.lastname: Chuang
authors.forename: N A
authors.initials: NA
authors.lastname: Lemak
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000286:Administration, Sublingual; D000556:Ambulatory Surgical Procedures; D000769:Anesthesia, Inhalation; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D008874:Midazolam / Q000008:administration & dosage*; D011292:Premedication; D011446:Prospective Studies
chemical_list: D000759:Adjuvants, Anesthesia; D006993:Hypnotics and Sedatives; D008874:Midazolam