Oral premedication with fentanyl may be a safe and effective alternative to oral midazolam.
OBJECTIVE
Although midazolam is commonly given orally to infants and small children for premedication, the taste is sometimes unacceptable even when mixed with syrup. We tested the efficacy and safety of oral fentanyl compared with oral midazolam in a randomized open-label study.


METHODS
Fifty-one children, aged 12-107 months and weighing 10-25 kg, were randomly assigned to fentanyl or midazolam treatment groups. Midazolam (5 mg) or fentanyl (0.1 mg) was given orally from a small bottle with a small orifice 30 min before transfer to the preoperative holding room. The excitation-sedation conditions of the patients were assessed before and after general anaesthesia.


RESULTS
The preoperative scores did not differ significantly between the two groups. No major complications were observed in either group. Postoperative vomiting occurred in 5 of 27 (18.5%) patients treated with oral fentanyl and in none of 24 of those treated with midazolam.


CONCLUSIONS
Oral administration of fentanyl 30 min before entrance to the holding room for an operation from a bottle with a small orifice is a premedication option for children between 1 and 8 yr of age.
Tamura
M
M
Osaka Dental University, Department of Anaesthesiology, Otemae, Osaka, Japan. ta69mu@yahoo.co.jp
Nakamura
K
K
Kitamura
R
R
Kitagawa
S
S
Mori
N
N
Ueda
Y
Y
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000627:therapeutic use*; D000284:Administration, Oral; D017677:Age Distribution; D001835:Body Weight / Q000502:physiology; D002675:Child, Preschool; D016292:Procedural Sedation; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D011229:Preanesthetic Medication; D014839:Vomiting / Q000139:chemically induced
D000759:Adjuvants, Anesthesia; D008874:Midazolam; D005283:Fentanyl