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Year : 2019  |  Volume : 22  |  Issue : 1  |  Page : 1-7

Effect of oral midazolam in preventing postoperative emergence agitation in children

1 Department of Anaesthesia, Bayero University Kano, Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Psychiatry, Bayero University Kano, Aminu Kano Teaching Hospital, Kano, Nigeria

Correspondence Address:
Dr. Atiku Mamuda
Department of Anaesthesia, Bayero University Kano, Aminu Kano Teaching Hospital, PMB 3452, Kano
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/smj.smj_32_17

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Introduction: Emergence from general anaesthesia can be complicated by the presence of agitation in children and thus presents a challenging situation for postanesthesia care providers. Several factors are associated with emergence agitation (EA). These include pain, preoperative anxiety, young age, poor adaptability, short time to recovery, among others. Objective: This study aimed to determine the effect of oral midazolam in preventing postoperative EA in children. Materials and Methods: This was a case–control study carried out among 80 healthy children aged 1–10 years scheduled for day-case surgery. The children were randomly assigned to receive either a syrup of paracetamol 10 mg/kg with injectable midazolam 0.5 mg/kg added to the syrup (Group A) or a placebo in the form of paracetamol syrup (Group B) at a dose of 10 mg/kg 30 min before induction of anesthesia. Patients' state of agitation was assessed every 5 min for the 1st h by means of an EA scale. Children with an agitation score of 3 or 4 were classified as agitated. Prolonged agitation was defined as a score of ≥3 lasting 15 min after arrival in the recovery room. Data were analyzed using the Statistical Software for Social Sciences version 20. Results: Eighty children aged 1–10 years were enrolled in the study. Majority of the procedures were circumcisions (48.75%), while urethral dilatation, examination under anesthesia, and tongue release were the least (1.25%). There was no statistically significant difference in the agitation state of the two groups (P = 0.60). Conclusion: Premedication with oral midazolam 0.5 mg/kg administered 30 min preoperatively does not prevent EA in all cases.

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