title: [Effects of intranasal midazolam premedication on inhaled induction of anesthesia with sevoflurane of pediatric patients].
abstract: OBJECTIVE
  To evaluate the effects of intranasal midazolam premedication on children who undergoing inhaled induction of anesthesia with sevoflurane.
  
  
  METHODS
  One hundred American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ children undergoing elective operations in Tianjin Medical University Cancer Institute and Hospital from June 2014 to June 2015 were randomly assigned into 2 groups, and 50 cases in each group. Patients received different intranasal premedication giving 30 min before anesthesia: midazolam 0.3 mg/kg (control group) and normal saline (placebo group) 2 ml. The following data were observed: the anxiety scores of the children in the preoperative interview (T1), before intranasal premedication (T2), during the induction room play (T3) and in the beginning of sevoflurane-inhaled induction (T4) using Modified Yale Preoperative Anxiety Scale (m-YPAS); the satisfaction scores of parents when children entering the operating room using Visual Analogue Scale (VAS); and the cooperation scores of the children receiving the sevoflurane-inhaled induction using Induction Compliance Checklist (ICC). The process of induction, the induction of sevoflurane and adverse incident were recorded.
  
  
  RESULTS
  The scores of m-YPAS of the induction room play (T3) and in the beginning of sevoflurane-inhaled induction (T4) of the control group were (26.48±9.04) and (40.88±17.31)scores, while those of the placebo group were (32.38±10.67) and (56.50±20.02) scores. The m-YPAS scores of the control group were significantly lower than those of the placebo group (t=2.983, 4.173, all P<0.05). The VAS of the control group and placebo group were (6.55±1.55) and (8.18±1.46) scores, the VAS of the control group was significantly lower than that of the placebo group (t=5.504, P<0.05). The total time of induction of the control group was (84.35±22.47)s, which was significantly shorter than that of the placebo group((104.21±31.05)s, t=3.664, P<0.05). The scores of m-YPAS in the preoperative interview (T1), before intranasal premedication (T2), the scores of ICC, the time of closing eyes and excitement phase of 2 groups had no significant difference (all P>0.05). There was no adverse incident happened in both groups.
  
  
  CONCLUSIONS
  Intranasal midazolam provided as premedication can reduce the anxiety for children undergoing inhaled induction of anesthesia with sevoflurane, and shorten the time of induction. It's a safe and effective method for premedication of pediatric anesthesia.
authors.affiliation: Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
authors.forename: R
authors.initials: R
authors.lastname: Wang
authors.forename: W H
authors.initials: WH
authors.lastname: Wang
mesh_terms: D000281:Administration, Intranasal; D000758:Anesthesia; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety / Q000517:prevention & control; D002648:Child; D006801:Humans; D008738:Methyl Ethers / Q000008:administration & dosage / Q000494:pharmacology*; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D011229:Preanesthetic Medication / Q000379:methods*; D011292:Premedication; D011595:Psychomotor Agitation / Q000517:prevention & control*; D000077149:Sevoflurane; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation; D014151:Anti-Anxiety Agents; D008738:Methyl Ethers; D000077149:Sevoflurane; D008874:Midazolam