European Journal of Biomedical and Pharmaceutical Sciences

EFFECTS OF INTRAVENOUS MIDAZOLAM AFTER ANESTHESIA INDUCTION ON EMERGENCE AGITATION IN SEVOFLURANE-NITROUS OXIDE ANESTHESIA FOR CHILDREN

Tomoki Nishiyama*

ABSTRACT

Emergence agitation is one of the biggest problem in pediatric anesthesia. The purpose was to investigate the effects of intravenous midazolam after induction of anesthesia with sevoflurane and nitrous oxide on emergence agitation in children. Seventy-five children aged 4 to 8 years for adenoidectomy or tonsillectomy were divided into three groups. Diazepam syrup 0.6 mg/kg was administered 2 hours before, and anesthesia was induced with halothane 4 % (H group), or sevoflurane 5% (S and M groups) in 50% nitrous oxide. Saline 5 mL (including midazolam 0.1 mg/kg in the M group only) was administered. At the end of surgery, nitrous oxide and halothane or sevoflurane were stopped. Hemodynamics and patients’ condition at induction and emergence of anesthesia, especially emergence agitation, were compared among the groups. Only S group showed increase in blood pressure after intubation. M group had significantly lower blood pressure than S group at extubation. Induction was faster in the M group than the H group. Emergence was slower in the H group than other two groups. Number of children with emergence agitation was significantly lower in the M group than the S group. In conclusion, intravenous midazolam 0.1 mg/kg at induction of anesthesia decreased emergence agitation in sevoflurane anesthesia lasted for about one hour in children aged 4 to 8 years without delaying emergence.

Keywords: pediatric anesthesia, inhalation anesthetic, intravenous anesthetics, emergence from anesthesia, agitation.