title: Comparison of a combination of midazolam and diazepam and midazolam alone as oral premedication on preanesthetic and emergence condition in children.
abstract: BACKGROUND
  Preanesthetic anxiety and emergence agitation are major challenges for anesthesiologists in pediatric anesthesia. Thus, midazolam has been used as premedication for children. However, midazolam alone is not effective for emergence agitation. The present study tested the effect of a combination of midazolam and diazepam on the preanesthetic condition and emergence behavior in children.
  
  
  METHODS
  Forty-two children were allocated to one of three groups: the NoPre group received no premedication; the Mi group received midazolam 0.5 mg kg(-1) orally; and the Mi + Di group received midazolam 0.25 mg kg(-1) and diazepam 0.25 mg kg(-1) orally. When anesthesia was induced with 7% sevoflurane in 100% oxygen, qualities of mask induction and sedation were rated. Anesthesia was maintained with sevoflurane (3-5%) in 100% oxygen. During emergence from anesthesia, the score of the child's emergence behavior was rated.
  
  
  RESULTS
  Children in the Mi and Mi + Di groups were more sedated than those in the NoPre group. A combination of midazolam and diazepam provided a better quality of mask induction, when compared with no premedication. Also, the children in the Mi + Di group were less agitated than those in the other groups during the emergence.
  
  
  CONCLUSIONS
  Children in the Mi + Di group were significantly more sedated at induction of anesthesia and less agitated during emergence from anesthesia.
authors.affiliation: Department of Anesthesiology, Kochi Medical School, Oko-Cho, Nankoku City, Kochi 783-8505, Japan. arainon@med.kochi-ms.ac.jp
authors.forename: Y-C P
authors.initials: YC
authors.lastname: Arai
authors.forename: K
authors.initials: K
authors.lastname: Fukunaga
authors.forename: S
authors.initials: S
authors.lastname: Hirota
mesh_terms: D000233:Adenoidectomy; D000758:Anesthesia; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D001049:Apnea / Q000139:chemically induced / Q000453:epidemiology; D001519:Behavior / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003975:Diazepam / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007223:Infant; D007442:Intubation, Intratracheal; D008297:Male; D008874:Midazolam / Q000009:adverse effects; D011229:Preanesthetic Medication / Q000009:adverse effects; D014068:Tonsillectomy
chemical_list: D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D003975:Diazepam; D008874:Midazolam