PREANESTHETIC MEDICATION WITH INTRANASAL MIDAZOLAM FOR BRIEF PEDIATRIC SURGICAL-PROCEDURES - EFFECT ON RECOVERY AND HOSPITAL DISCHARGE TIMES

Background: The perfect preanesthesia medication and its ideal route o f administration are still debated, but for pediatric surgical patient s undergoing brief procedures, preanesthesia medication is frequently omitted because of the concern that it will prolong the child's recove ry from anesthesia. The effects of nasally administered midazolam on a nesthetic recovery and hospital discharge times were determined in 88 ASA physical status 1 and 2 ambulatory surgical patients undergoing a brief surgicalprocedure. Methods: Using a randomized, double-blind, pl acebo-controlled design, 88 ambulatory surgical patients 10-36 months of age undergoing myringotomy and tube insertion were entered into the study. All patients were randomly assigned to one of three medication groups. One group received 0.2 mg/kg intranasal midazolam; a second g roup received 0.3 mg/kg intranasal midazolam; and the third group rece ived intranasal saline drops. All patients were anesthetized with nitr ous oxide, oxygen, and halothane administered via mask. The duration o f anesthesia lasted between 9 and 10 min. After preanesthetic medicati on, the children were evaluated for ease of separation and induction o f anesthesia, In addition, the time from when the anesthetic was disco ntinued until the child recovered from anesthesia and the time the chi ld was discharged home were recorded by a nurse observer blinded to th e patient grouping. Results: Children receiving midazolam had smoother , calmer parent-child separation and anesthesia induction scores, and their anesthesia recovery times and hospital discharge times were the same as those receiving placebo. Conclusions: For children undergoing brief surgical procedures, nasal midazolam provides satisfactory anxio lysis without delaying anesthesia recovery and hospital discharge.