title: Is premedication with midazolam more effective by the sublingual than the oral route?
abstract: BACKGROUND
  In this study, we compared the sedative effects of sublingual midazolam solution with the oral tablet as premedication. Sixty pediatric patients of ASA physical status I and II were randomly selected to receive either 0.5 mg/kg of tablet or 0.5 mg/kg of sublingual solution of midazolam as premedication, about 45 min before elective surgery.
  
  
  METHODS
  There were 30 patients in each group. In Group I, the patients received premedication in the form of oral midazolam tablet 0.5 mg/kg. In Group II, the patients received midazolam solution 0.5 mg/kg. The degree of sedation and ease of separation was assessed according to the Niall C. Wilton scale and the procedure of Davis Peter, respectively. The time for complete drug dissolution was noted in both the groups. Then, the patients were interviewed regarding their acceptance of taste.
  
  
  RESULTS
  The sedation scores in the sublingual group were higher than in the oral group at 30 and 45 min after drug administration (P=0.0134 and P=0.0157). 66.6% of the patients in the sublingual group found it satisfactory as compared to 53.3% in the case of group receiving tablet.
  
  
  CONCLUSIONS
  Thus, from the present study, it is concluded that premedication with midazolam is more effective by the sublingual than the oral route in children.
authors.affiliation: Department of Anesthesiology, M. P. Shah Medical College, Guru Gobind Singh Hospital, Jamnagar, Gujarat, India.
authors.forename: Shobhana
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Anesthesiology, M. P. Shah Medical College, Guru Gobind Singh Hospital, Jamnagar, Gujarat, India.
authors.forename: Hina
authors.initials: H
authors.lastname: Gadani
authors.affiliation: Department of Anesthesiology, M. P. Shah Medical College, Guru Gobind Singh Hospital, Jamnagar, Gujarat, India.
authors.forename: Shravan
authors.initials: S
authors.lastname: Kedia
keywords: Children; midazolam; premedication