title: A randomized trial examining preoperative sedative medication and postoperative sleep in children.
abstract: OBJECTIVE
  Midazolam has been found to have beneficial effects on anxiety in children in the preoperative setting. Prior studies have examined various postoperative behaviors of children, but little research has examined the effects of preoperative use of midazolam with postoperative sleep. The purpose of this investigation was to compare postoperative sleep in children as a function of preoperative sedative medication use.
  
  
  METHODS
  This study was a 2-group randomized controlled trial.
  
  
  METHODS
  Participants were recruited from Yale-New Haven Children's Hospital.
  
  
  METHODS
  Participants included a convenience sample of 70 children between the ages of 3 to 12 years undergoing ambulatory tonsillectomy and adenoidectomy.
  
  
  METHODS
  Children were randomly assigned to 1 of 2 groups: a control group who received preoperative acetaminophen only (n = 32) and an experimental group who received both acetaminophen and midazolam preoperatively (n = 38).
  
  
  METHODS
  Parents completed measures of postoperative behavioral recovery and a subset of children wore actigraphs to examine objective sleep data.
  
  
  RESULTS
  Children who received midazolam experienced similar sleep changes compared to children in the control group. The actigraph data revealed that children who received midazolam were awake significantly less during the night compared to the control group (P= .01).
  
  
  CONCLUSIONS
  Children who received midazolam before surgery had similar postoperative sleep changes compared to children who did not receive midazolam. Further understanding of the postoperative behavioral effects of midazolam on children will help guide healthcare providers in their practice.
authors.affiliation: Department of Pediatric Psychology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Min
authors.affiliation: Department of Anesthesiology and Perioperative Care, University of California Irvine, USA; Department of Pediatrics, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Zeev N
authors.initials: ZN
authors.lastname: Kain
authors.affiliation: Department of Pediatric Psychology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Stevenson
authors.affiliation: Department of Anesthesiology and Perioperative Care, University of California Irvine, USA.
authors.forename: Brooke
authors.initials: B
authors.lastname: Jenkins
authors.affiliation: Department of Pediatric Psychology, CHOC Children's Hospital, Orange, CA, USA; Department of Anesthesiology and Perioperative Care, University of California Irvine, USA. Electronic address: mfortier@uci.edu.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Fortier
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D056044:Actigraphy; D000233:Adenoidectomy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods; D012890:Sleep / Q000187:drug effects*; D014068:Tonsillectomy / Q000379:methods
chemical_list: D006993:Hypnotics and Sedatives; D000082:Acetaminophen; D008874:Midazolam
keywords: Actigraphy; Midazolam; Pediatrics; Post-operative period