Oral midazolam as pre-anesthetic medication in children and teenagers with cerebral palsy. A comparative study on the variations of the bispectral index.
OBJECTIVE
Midazolam is a benzodiazepine with hypnotic action widely used as pre-anesthetic medication in pediatric anesthesia. Children with cerebral palsy (CP) also benefit from the use of midazolam, but its effects on this group of patients, who present several particularities, including changes at the site of action of midazolam, are still unknown. The objective of this study was to evaluate the effects of midazolam, when used as pre-anesthetic medication, on the bispectral index (EEG-BIS) of patients with cerebral palsy.


METHODS
Two groups of patients were evaluated: one group with the diagnosis of CP and the other without central and peripheral nervous system disorders. The EEG-BIS was recorded in the room, the day before the surgery and at the day of the surgery, 40 minutes after the administration of 0.6 mg.kg(-1) of oral midazolam. Patients with a history of paradoxal reaction to midazolam as well as patients in the control group who were using other medications were excluded.


RESULTS
Seventy-seven patients of both genders, 4 to 18 years old, participated in this study. Differences in EEG-BIS between both groups were not detected. After the use of midazolam EEG-BIS decreased in both groups with a statistically significant difference in each group. Statistically significant intergroup differences were not observed.


CONCLUSIONS
Midazolam, used as pre-anesthetic medication, at a dose of 0.6 mg.kg(-1), reduced basal EEG-BIS without characterizing hypnosis and without statistically significant differences between the study groups.
da Costa
Verônica Vieira
VV
Hospital SARAH, Brasília, DF. veve@bsb.sarah.br
Torres
Rafael Villela Silva Derré
RV
Arci
Erika Carvalho Pires
EC
Saraiva
Renato Angelo
RA
D000284:Administration, Oral; D000293:Adolescent; D002547:Cerebral Palsy; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007430:Intraoperative Care; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D011229:Preanesthetic Medication; D011446:Prospective Studies
D006993:Hypnotics and Sedatives; D008874:Midazolam