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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 1998 November;64(11):499-504

language: Italian

Premedication with intranasal midazolam in children of different ages

Vivarelli R. 1, Zanotti F. 1, Battaglia D. 1, Caggese G. 1, Sella G. 1, Gilli G. 2, Guberti A. 1

1 Azienda Ospedaliera Arcispedale S. Anna - Ferrara, Servizio II di Anestesia e Rianimazione;
2 Azienda Ospedaliera Arcispedale S. Anna - Ferrara, Servizio di Fisica Sanitaria


Background and aim. To evaluate the efficacy of premedication with midazolam (mdz) administered using a nasal route compared to diazepam (dz) administered by mouth in children of different ages.
Experimental design. A comparative type study was performed in randomly selected pediatric patients undergoing surgery. The study lasted 3 months.
Setting. Recovery room and operating theatre for Pediatric Surgery and ENT.
Patients. A total of 248 patients were studied, divided into 3 age groups: group A were aged under 2 years; group B were pre-school age and group C were school-age.
Operations. Two subgroups were formed based on the premedication used: group M= 0.2 mg/kg of mdz using a nasal route on arrival in the operating unit; group D= 0.2 mg/kg of dz per os 45’ before induction.
Parameters studied. In addition to acceptance of treatment, which was deemed to be good, poor or refused, the authors evaluated the level of sedation (score from 5 to 1: awake - asleep), anxiety on entering SO (score from 1 to 4: none- excessive) and the level of collaboration during the induction of general anesthesia (score 1-4: excellent - nil).
Results. The nasal route was well accepted by 59% of patients in group A, 62% of group B and 97% of group C. Statistical analysis using Kruskall Wallis test showed significant differences in groups A and B between the two subgroups M and D for all the parameters studied, whereas there were no significant differences in group C.
Conclusions. Premedication with mdz using a nasal route was safe and efficacious, above all in early and later infancy.

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