[Regional cerebral hypoperfusion reduces the effect of rectal midazolam in children with Moyamoya disease].

To investigate the effect of regional cerebral blood flow on the effect of midazolam, we evaluated 99mTc-hexamethylpropylene-amine-oxime-single photon emission computed tomography (SPECT) in 37 cases of childhood moyamoya disease. They were divided into two groups according to the findings of SPECT; one group showed hypoperfusion in the bifrontal regions (n = 20), and the other did not (n = 17). Both groups received 1 mg.kg-1 of midazolam transrectally 30 min before the anesthesia induction and level of sedation was measured with six point scales. Significantly lower level of sedation score was recognized in the group that showed hypoperfusion in bifrontal regions (P < 0.05). Our finding may suggest that regional cerebral hypoperfusion may modify the sedative effect of midazolam in children with moyamoya disease.