ORAL MIDAZOLAM PREMEDICATION FOR PEDIATRIC DAY-CASE PATIENTS

Forty-nine children having day-stay surgical procedures were randomly assigned to receive oral midazolam 0.75 mg . kg(-1) or placebo in a do uble blind fashion. The child's level of anxiety was assessed before p remedication using parental, child and observer scales. The child and observer anxiety scores were repeated in the anaesthetic room. Most ch ildren presented for anaesthesia in a calm state, irrespective of whet her they had received midazolam. Parents tended to overestimate their child's level of anxiety. Observer anxiety scores reliably predicted b ehaviour during induction of anaesthesia in the absence of a sedative. Observer scores decreased in the midazolam group (P<0.02), but not in the placebo group, children below six years having the greatest decre ase with midazolam. The median time to discharge from hospital was del ayed by 30 min in the midazolam group (P<0.01). Children do not requir e routine sedative premedication for day case procedures, but oral mid azolam is useful in producing calm behaviour in those children with hi gh observer anxiety scores.