[Psychosomatic, sedative and hemodynamic reactions following preoperative administration of midazolam in children].

Since children's intellectual perception is limited, the preoperative visit by an anesthesiologist alone can rarely help to free the small patients from fear and restlessness prior to elective surgery. In order to relieve anxiety which should be the primary goal of premedication in any patient - children need anxiolytic premedication agents. Drugs for premedication administered by intramuscular or rectal route in children often cause pain, fear and discomfort. The present study was performed in order to investigate oral given midazolam in the premedication of children with special regard to the practical suitability of this method. 100 children, 0.5 to 10 years of age (group A: 0.5-4 years, group B: 5-10 years) undergoing elective urological surgery received 0.4 mg/kg midazolam orally about 20 minutes prior to the arrival in the operation unit. After insertion of a venous cannula into a forearm vein anesthesia was induced with thiopental and maintained by inhalation with Isoflurane, nitrous oxide and oxygen (fi O2:0.3). Degree of sedation, state of mind and behaviour (for 100 children) as well as blood pressure and heart rate (separately for group A and B) were registered preoperatively at defined, comparable and representative circumstances. Side effects prior and during induction phase of anesthesia were documented. The personal data are representative for a normal population of children with typical urological diseases. Oral administered midazolam had only a mild or non sedative effect in 76-84% of the children 70-84% of the small patients showed an indifferent or euphoric state of mind and 67-88% behaved cooperatively or passively.(ABSTRACT TRUNCATED AT 250 WORDS)