title: The effects of single-dose rectal midazolam application on postoperative recovery, sedation, and analgesia in children given caudal anesthesia plus bupivacaine.
abstract: BACKGROUND
  This study aimed to compare the effects of rectal midazolam addition after applying bupivacaine and caudal anesthesia on postoperative analgesia time, the need for additional analgesics, postoperative recovery, and sedation and to find out its adverse effects in children having lower abdominal surgery.
  
  
  METHODS
  40 children between 2 and 10 years of ASA I-II were randomized, and they received caudal anesthesia under general anesthesia. Patients underwent the application of caudal block in addition to saline and 1 mL/kg bupivacaine 0.25%. In the postoperative period, Group C (n = 20) was given 5 mL saline, and Group M (n = 20) was given 0.30 mg/kg rectal midazolam diluted with 5 mL saline. Sedation scale and postoperative pain scale (CHIPPS) of the patients were evaluated. The patients were observed for their analgesic need, first analgesic time, and adverse effects for 24 hours.
  
  
  RESULTS
  Demographic and hemodynamic data of the two groups did not differ. Postoperative sedation scores in both groups were significantly lower compared with the preoperative period. There was no significant difference between the groups in terms of sedation and sufficient analgesia.
  
  
  CONCLUSIONS
  We conclude that caudal anesthesia provided sufficient analgesia in peroperative and postoperative periods, and rectal midazolam addition did not create any differences. This trial is registered with ClinicalTrials.gov NCT02127489.
authors.affiliation: Department of Anesthesiology and Reanimation, Kanuni Education and Research Hospital, 61290 Trabzon, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Saylan
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Eroglu
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Davut
authors.initials: D
authors.lastname: Dohman
mesh_terms: D000005:Abdomen / Q000473:pathology / Q000601:surgery*; D000762:Anesthesia Recovery Period; D000763:Anesthesia, Caudal; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D011184:Postoperative Period
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D002045:Bupivacaine