Oral midazolam with an antacid may increase the speed of onset of sedation in children prior to general anaesthesia.
BACKGROUND
The aim of the study was to see whether sodium citrate solution would speed the gastric absorption of oral midazolam.


METHODS
Forty presurgical ASA I and II patients (aged 2-6 years) were randomly assigned to one of two groups. Group I received midazolam 0.5 mg x kg(-1) mixed with sodium citrate while group II (control) received midazolam 0.5 mg x kg(-1) mixed with Hawaiian fruit punch.


RESULTS
There was no statistical difference between the ages, weights, preoperative sedation and anxiety scores in the two groups. After premedication, the onset of sedation (mean +/- SD) measured by the first change in sedation score was found to be significantly faster (P < 0.05) in group I (17.8 +/- 7.11) compared with group II (21.9 +/- 5.34). There was no statistical difference in anxiety at any time intervals, separation or induction scoring for both groups. Gastric volumes and the pH of gastric aspirates between the two groups were not statistically significant.


CONCLUSIONS
The time to onset of sedation can potentially be shortened, by using a preparation of intravenous midazolam and antacid, given orally.
Lammers
C R
CR
Department of Anesthesia, Stanford University Medical Center, Stanford, CA 94305-5640, USA.
Rosner
J L
JL
Crockett
D E
DE
Chhokra
R
R
Brock-Utne
J G
JG
D000284:Administration, Oral; D000768:Anesthesia, General; D000863:Antacids / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002951:Citrates / Q000008:administration & dosage*; D004311:Double-Blind Method; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008874:Midazolam / Q000008:administration & dosage* / Q000493:pharmacokinetics; D011229:Preanesthetic Medication; D000077559:Sodium Citrate; D013997:Time Factors
D000863:Antacids; D002951:Citrates; D006993:Hypnotics and Sedatives; D000077559:Sodium Citrate; D008874:Midazolam