title: Postoperative agitation in preschool children following emergence from sevoflurane or halothane anesthesia: a randomized study on the forestalling effect of midazolam premedication versus parental presence at induction of anesthesia.
abstract: OBJECTIVE
  The effect of midazolam premedication on forestalling postoperative agitation in children is not yet concluded. The purpose of this study was to compare the effects of midazolam premedication and parental presence during anesthetic induction on the incidence of postoperative agitation in pediatric patients.
  
  
  METHODS
  One hundred sixty-seven children between 2 years and 7 years of age, undergoing anesthesia for outpatient surgery, were enrolled and randomly divided into four groups: sevoflurane anesthesia with parental presence without premedication, sevoflurane anesthesia with oral midazolam premedication, halothane anesthesia with parental presence without premeditation, and halothane anesthesia with oral midazolam premedication. The children randomized to the premedication groups took oral midazolam 0.5mg/kg 20-30 minutes before anesthetic induction. For patients in the groups without premedication, one of the parents was present throughout the induction of anesthesia. One recovery room nurse blinded to the group assignment observed the patients and recorded the agitation scores all through their stay in the postanesthesia care unit.
  
  
  RESULTS
  Postoperative agitation was significantly less in patients who received halothane anesthesia with oral midazolam premedication (p<0.002).
  
  
  CONCLUSIONS
  Based on our data, the presence of a parent at induction of sevoflurance anesthesia was as effective as midazolam premedication in decreasing the incidence of postoperative agitation. Midazolam premedication, however, decreased postoperative agitation when halothane was used as the anesthetic agent.
authors: Department of Anesthesiology, Shiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Farid
authors: F
authors: Zand
authors: Elaheh
authors: E
authors: Allahyary
authors: Ali R
authors: AR
authors: Hamidi
mesh_terms: D000769:Anesthesia, Inhalation; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006221:Halothane / Q000494:pharmacology*; D006801:Humans; D015994:Incidence; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008874:Midazolam / Q000627:therapeutic use*; D010290:Parents; D011183:Postoperative Complications / Q000453:epidemiology*; D011229:Preanesthetic Medication; D011595:Psychomotor Agitation / Q000453:epidemiology*; D000077149:Sevoflurane
chemical_list: D014151:Anti-Anxiety Agents; D008738:Methyl Ethers; D000077149:Sevoflurane; D008874:Midazolam; D006221:Halothane