SUBLINGUAL MIDAZOLAM PREMEDICATION IN CHILDREN - A DOSE-RESPONSE STUDY

The purpose of this study was to evaluate various doses of sublingual midazolam premedication in children. In our prospective, double-blind, placebo-controlled trial, children (n = 102, age range 12 to 129 mont hs) scheduled for day surgery were randomized to receive either midazo lam in one of three doses (0.25, 0.5, or 0.75 mg.kg(-1)) or placebo. I njectable midazolam was mixed with a thick grape syrup and placed unde r the tongue; the patient was asked to hold it as long as possible bef ore swallowing. Children readily accepted the mixture. Analysing all p atients randomized, none of the children receiving placebo vs 28% rece iving 0.25 mg.kg(-1) (P = 0.02), 52% receiving 0.5 mg.kg(-1) (P<0.001) , and 64% receiving 0.75 mg.kg(-1) (P<0.001) of midazolam showed satis factory sedation (drowsy) at 15 min after administration. Children rec eiving the two higher doses of midazolam (0.5 and 0.75 mg.kg(-1)) acce pted mask induction willingly, while the group receiving 0.25 mg.kg(-1 ) resembled the placebo group (P<0.05).