[Amnesic effect of oral midazolam as premedication in children].
ABSTRACT We evaluated the sedative and amnesic effects of oral midazolam as premedication in children. Sixteen children, aged 4-12 yr, undergoing elective minor surgery were divided into 2 groups. One group received midazolam 0.5 mg.kg-1 with atropine 0.03 mg.kg-1 orally. The other control group received only atropine 0.03 mg.kg-1. There was no significant difference in the sedative scale at induction between the 2 groups. Doll-recall was used to assess the amnesic effects. In the midazolam group, 75% of the children forgot dolls they had seen on entering the operating room. Midazolam produced significant anterograde amnesia but no retrograde amnesia. This result suggests that children who received midazolam as premedication forget unpleasant memories at induction and their postoperative emotional responses are least influenced by their memories. We conclude that oral midazolam 0.5 mg.kg-1 is an effective preanesthetic medication in children.
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ABSTRACT: This study compared 2 oral ketamine-diazepam regimens (8 mg/kg and 10 mg/kg of ketamine in combination with 0.1 mg/kg diazepam) in preschool age children with respect to physiological, behavioral and amnestic parameters. Twenty-five children completed the double-blind, crossover design. Physiologic, behavioral and amnestic effects were evaluated. ANOVA demonstrated significant changes in systolic blood pressures and heart rates in both the 8 mg/kg group and 10 mg/kg group (P < 0.05), as well as significant changes in diastolic blood pressures in the 10 mg/kg group (P < 0.05). However, these changes were not clinically significant. Success rates were 28% for the 8 mg/kg dosage and 44% for the 10 mg/kg dosage. There was a cumulative vomiting rate of 50% and a psychic phenomena rate of 10%. There were no statistically significant differences between the two dosages with regard to success rates, postoperative vomiting, or psychic phenomena using McNemar's test. There is no advantage of 10 mg/kg dose of ketamine over the 8 mg/kg dose. Ketamine did not demonstrate amnestic effects in this study. There were statistically but no clinically significant changes in physiological parameters in either group. This study does not support the use of either 8 mg/kg or 10 mg/kg oral ketamine for the sedation of uncooperative children.Pediatric dentistry 23(3):223-31. · 0.56 Impact Factor
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ABSTRACT: To compare the efficacy and safety of a single dose of midazolam, as an oral solution of 0.5 mg/kg, or nasal drops of 0.25 mg/kg, in children undergoing emergency department laceration repair. Double-blind, double-placebo, randomized trial. Children underwent standard wound care when judged to demonstrate a reduction in anxiety following study medication. Fifty-eight patients between 1 and 10 years of age with uncomplicated lacerations judged to be anxious by emergency physicians. An anxiety score and vital signs were recorded at routine intervals. Groups were comparable with respect to age, laceration characteristics, initial vital signs, and anxiety scores. Both groups demonstrated reductions (mean +/- SD) in anxiety scores over time (P < .05; maximum at 10 minutes; 1.2 +/- 0.9 mm for nasal and 0.8 +/- 1.3 for oral), with no significant differences between groups (repeat-measures ANOVA). Median observer-rated effectiveness using a visual analog scale (maximum effectiveness, 10 mm) was not significantly different between groups: nasal, 7.6 mm and oral, 6.9 (Mann-Whitney U test: minimum detectable difference, 0.7, with alpha = 0.05 and beta = 0.2). Complications were judged to be minor only, and were more frequent in the nasal group (5 of 28, 4 with nasal burning) versus 1 of 26 in the oral group. Time from midazolam to ED discharge was not significantly different between groups: nasal, 54 +/- 15 minutes and oral, 57 +/- 16 minutes. A single dose of oral or nasal midazolam results in reduced anxiety and few complications in selected children undergoing laceration repair in the ED. The oral route was associated with fewer administration problems.Annals of Emergency Medicine 12/1994; 24(6):1074-9. DOI:10.1016/S0196-0644(94)70236-5 · 4.33 Impact Factor
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ABSTRACT: In einer Doppelblindstudie mit 31 Probanden wurden durch Anwendung eines standardisierten und validierten Testverfahrens (SKT) kognitive Leistungsstörungen nach einmaliger oraler Aufnahme einer therapeutischen Dosis von 15 mg Midazolam quantitativ erfaßt. Die Störungen entsprachen teilweise dem klinischen Bild eines mittelgradigen bis schweren Durchgangssyndroms oder organischen Psychosyndroms. Zusätzlich trat bei allen Probanden eine komplette anterograde Amnesie ohne Aufhellungstendenz auf. Motorische Koordinationsstörungen wurden besonders durch den Nachweis eines grobschlägigen Drehnystagmus deutlich, der bei 25 Probanden verlängert war. Alle subjektiven und objektiven Wirkungen waren auf den Zeitraum der ersten 3 bis 6 Stunden nach Midazolameinnahme beschränkt. In a double-blind study with 31 volunteers, disturbances of cognitive performance following the uptake of 15 mg oral midazolam were examined by a standardised and validated test (SKT). The degrees of impaired cognitive efficiency were comparable to those of moderate or serious organic psychosyndrome. Furthermore, a complete anterograde amnesia without any tendency to clarify was obvious in all cases. Disturbances of motor coordination were particularly evident from a rotatory nystagmus which showed a prolonged coarse tremor in 25 volunteers. All subjective and objective effects were limited to a time period of 3–6 h after midazolam administration.Rechtsmedizin 01/1998; 8(2):64-68. DOI:10.1007/s001940050031 · 0.63 Impact Factor