COMPARISON OF RECTAL TO INTRANASAL ADMINISTRATION OF MIDAZOLAM FOR PREMEDICATION OF CHILDREN

Sixty children aged 3 to 9, undergoing minor surgical procedures, were studied to compare 0.5 mg/kg intranasal with 0.5 mg/kg rectal midazol am as a premedication. The children were evaluated for their ability t o tolerate the medication, preanesthestic sedation, and alertness afte r anesthesia, Both premedication routes were equally effective in seda ting the children. In both groups, a significant loss of effectiveness was noted if induction of the anesthesia began more than 30 minutes a fter administration of the medication (p < 0.0003). Rectal midazolam w as much better tolerated by the children than the intranasal route (30 versus 3, p < 0.0001), We advocate the rectal over the intranasal rou te for premedication with midazolam in children, and anesthestic induc tion should occur no more than 30 minutes after administration of prem edication.