Feld L H, Negus J B, White P F
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110.
Anesthesiology. 1990 Nov;73(5):831-4. doi: 10.1097/00000542-199011000-00006.
A need exists for a safe and effective oral preanesthetic medication for use in children undergoing elective surgical procedures. We evaluated the effectiveness of three different doses of oral midazolam when administered in combination with atropine prior to ambulatory surgery. In this randomized, double-blind, placebo-controlled study, 124 children, ages 1-10 yr, received midazolam, 0.25, 0.50, or 0.75 mg.kg-1 po, and atropine, 0.03 mg.kg-1 po, mixed with apple juice, or a placebo (containing the midazolam vehicle, atropine, and apple juice). A blinded observer noted the child's level of sedation, the quality of separation from parents, and the degree of cooperation with an inhalation induction of anesthesia. Picture-recall was used to assess the amnesic effect of midazolam in children over 5 yr of age. Midazolam 0.75 mg.kg-1 produced significant sedation at 30 min. After procedures lasting an average of 106-113 min, recovery was not prolonged by the oral midazolam-atropine combination. We concluded that oral midazolam 0.5-0.75 mg.kg-1 is an effective preanesthetic medication for pediatric outpatients.
对于接受择期外科手术的儿童，需要一种安全有效的口服麻醉前用药。我们评估了在门诊手术前联合使用阿托品时三种不同剂量口服咪达唑仑的有效性。在这项随机、双盲、安慰剂对照研究中，124名1至10岁的儿童接受了0.25、0.50或0.75毫克/千克口服咪达唑仑以及0.03毫克/千克口服阿托品，二者与苹果汁混合，或接受安慰剂（含有咪达唑仑溶媒、阿托品和苹果汁）。一名盲法观察者记录了儿童的镇静程度、与父母分离的质量以及对吸入诱导麻醉的合作程度。使用图片回忆法评估咪达唑仑对5岁以上儿童的遗忘效果。0.75毫克/千克的咪达唑仑在30分钟时产生了显著的镇静作用。在平均持续106至113分钟的手术之后，口服咪达唑仑 - 阿托品联合用药并未延长恢复时间。我们得出结论，0.5至0.75毫克/千克的口服咪达唑仑是一种有效的儿科门诊患者麻醉前用药。
