Shoroghi Mehrdad, Arbabi Shahriyar, Farahbakhsh Farshid, Sheikhvatan Mehrdad, Abbasi Ali
Department of Anaesthesia, Razi Hospital, Tehran University of Medical Sciences, Iran.
Acta Cir Bras. 2011 Aug;26(4):303-9. doi: 10.1590/s0102-86502011000400010.
To investigate and compare the efficacy of oral midazolam with two different dosages in orange juice on perioperative hemodynamics and behavioral changes in children who underwent skin laser treatment in an academic educational Hospital.
Ninety children, candidates for skin laser treatment were randomly assigned to 1 of 3 groups of 30 each: the placebo group received 0.1 ml/kg orange flavored juice, group 2 and 3 receiving 0.5 and 1 mg/kg of injectable midazolam mixed with an equal volume of orange juice, respectively. The main outcome measures included the mask acceptance, patients' behavioral scales and postoperative events.
There were no significant differences in heart rate, respiratory rate, and systolic blood pressure among the three groups. However, arterial oxygen saturation was significantly reduced in those given 1 mg.kg(-1) midazolam. The median scores of anxiety, separation from parent, preparing an intravenous line, acceptance of the oxygen mask, good sedation, crying reduction and consciousness level were better in midazolam group. Postoperative agitation and re-crying were also more frequent in placebo receivers. Those given 1 mg.kg(-1) midazolam were significantly more optimal for sedation, crying, consciousness, preparing an intravenous line, and postoperative re-crying compared with 0.5 mg.kg(-1) midazolam receivers.
As a preanaesthetic medication, the 1 mg.kg(-1) dose of orally given midazolam especially in a volume of orange juice and can optimize the children's behavior during skin laser treatment with no serious adverse effects, enhancing their parents' satisfactions about the sedative protocol.
在一所学术教学医院，调查并比较两种不同剂量的咪达唑仑加入橙汁后口服给药，对接受皮肤激光治疗儿童围手术期血流动力学及行为变化的影响。
90名拟接受皮肤激光治疗的儿童被随机分为3组，每组30人：安慰剂组接受0.1 ml/kg的橙汁，第2组和第3组分别接受0.5和1 mg/kg的注射用咪达唑仑与等体积橙汁混合液。主要观察指标包括面罩接受度、患者行为量表及术后情况。
三组间心率、呼吸频率及收缩压无显著差异。然而，给予1 mg·kg⁻¹咪达唑仑的患儿动脉血氧饱和度显著降低。咪达唑仑组在焦虑、与父母分离、准备静脉通路、接受氧面罩、良好镇静、哭声减少及意识水平方面的中位数评分更高。安慰剂组术后躁动及再次哭闹也更频繁。与接受0.5 mg·kg⁻¹咪达唑仑的患儿相比，接受1 mg·kg⁻¹咪达唑仑的患儿在镇静、哭声、意识、准备静脉通路及术后再次哭闹方面明显更优。
作为麻醉前用药，1 mg·kg⁻¹剂量的口服咪达唑仑加入橙汁中，尤其可优化儿童皮肤激光治疗期间的行为，且无严重不良反应，提高其父母对镇静方案的满意度。
