Malinovsky J M, Lejus C, Servin F, Lepage J Y, Le Normand Y, Testa S, Cozian A, Pinaud M
Département d'Anesthésie-Réanimation Chirurgicale, Hôtel-Dieu, CHRU, Nantes, France.
Br J Anaesth. 1993 Jun;70(6):617-20. doi: 10.1093/bja/70.6.617.
Midazolam is used frequently for premedication in children, preferably by non-parenteral administration. We have compared plasma concentrations of midazolam after nasal, rectal and i.v. administration in 45 children (aged 2-9 yr; weight 10-30 kg) undergoing minor urological surgery. General anaesthesia consisted of spontaneous respiration of halothane and nitrous oxide in oxygen via a face mask. After administration of atropine and fentanyl i.v., children were allocated randomly to receive midazolam 0.2 mg kg-1 by the nasal, rectal or i.v. route. In the nasal group, children received 50% of the dose of midazolam in each nostril. In the rectal group, midazolam was given rectally via a cannula. Venous blood samples were obtained before and up to 360 min after administration of the drug. Plasma concentrations of midazolam were measured by gas chromatography and electron capture detection. After nasal and rectal administration, midazolam Cmax was 182 (SD 57) ng ml-1 within 12.6 (5.9) min, and 48 (16) ng ml-1 within 12.1 (6.4) min, respectively. Rectal administration resulted in smaller plasma concentrations. In the nasal group, a plasma concentration of midazolam 100 ng ml-1 occurred at about 6 min. After 45 min, the concentration curves after i.v. and nasal midazolam were similar.
咪达唑仑常用于儿童术前用药，最好采用非肠道给药途径。我们比较了45名接受小儿泌尿外科小手术的儿童（年龄2 - 9岁；体重10 - 30 kg）经鼻、直肠和静脉注射咪达唑仑后的血浆浓度。全身麻醉包括通过面罩自主呼吸氟烷和笑气与氧气的混合气。静脉注射阿托品和芬太尼后，将儿童随机分为经鼻、直肠或静脉注射途径接受0.2 mg/kg咪达唑仑的组。在经鼻组中，儿童每个鼻孔接受一半剂量的咪达唑仑。在直肠组中，咪达唑仑通过套管直肠给药。在给药前及给药后长达360分钟采集静脉血样。采用气相色谱和电子捕获检测法测定咪达唑仑的血浆浓度。经鼻和直肠给药后，咪达唑仑的Cmax分别在12.6（5.9）分钟内为182（标准差57）ng/ml，在12.1（6.4）分钟内为48（16）ng/ml。直肠给药导致的血浆浓度较低。在经鼻组中，约6分钟时咪达唑仑血浆浓度达到100 ng/ml。45分钟后，静脉注射和经鼻注射咪达唑仑后的浓度曲线相似。
