Cray S H, Dixon J L, Heard C M, Selsby D S
Department of Anaesthesia, General Infirmary, Leeds, UK.
Paediatr Anaesth. 1996;6(4):265-70. doi: 10.1111/j.1460-9592.1996.tb00448.x.
Forty-nine children having day-stay surgical procedures were randomly assigned to receive oral midazolam 0.75 mg.kg-1 or placebo in a double blind fashion. The child's level of anxiety was assessed before premedication using parental, child and observer scales. The child and observer anxiety scores were repeated in the anaesthetic room. Most children presented for anaesthesia in a calm state, irrespective of whether they had received midazolam. Parents tended to overestimate their child's level of anxiety. Observer anxiety scores reliably predicted behaviour during induction of anaesthesia in the absence of a sedative. Observer scores decreased in the midazolam group (P < 0.02), but not in the placebo group, children below six years having the greatest decrease with midazolam. The median time to discharge from hospital was delayed by 30 min in the midazolam group (P < 0.01). Children do not require routine sedative premedication for day case procedures, but oral midazolam is useful in producing calm behaviour in those children with high observer anxiety scores.
四十九名接受日间手术的儿童被随机分配，以双盲方式接受0.75毫克/千克的口服咪达唑仑或安慰剂。在术前用药前，使用家长、儿童和观察者量表评估儿童的焦虑程度。在麻醉室重复测量儿童和观察者的焦虑评分。大多数儿童在麻醉时处于平静状态，无论他们是否接受了咪达唑仑。家长往往高估孩子的焦虑程度。在没有镇静剂的情况下，观察者的焦虑评分可靠地预测了麻醉诱导期间的行为。咪达唑仑组观察者评分降低（P<0.02），而安慰剂组未降低，六岁以下儿童使用咪达唑仑后降低幅度最大。咪达唑仑组的中位出院时间延迟了30分钟（P<0.01）。对于日间手术，儿童不需要常规的镇静术前用药，但口服咪达唑仑有助于使观察者焦虑评分高的儿童表现出平静的行为。
