ORAL ADMINISTRATION OF INTRAVENOUS SOLUTION OF MIDAZOLAM MIXED WITH HONEY AS PREMEDICATION IN CHILDREN TO ALLOW EASY SEPARATION FROM PARENTS BEFORE SURGERY

Dr. Mudasira Yaseen, Dr. Khalid Sofi and Dr. Azka Sunain*

ABSTRACT

Objective: This was a prospective, observational study, conducted to evaluate the efficacy of intravenous solution of midazolam used orally mixed with honey as premedication in children undergoing infraumbilical surgeries. Methods: The study included, ASA class I and II children, aged 1-8 year. The children were assessed for sedation score and ease of separation from their parents in the holding area of the operating room, 45 minutes after oral administration of intravenous solution of midazolam mixed with honey. The sample size was 300 (100 patients per group). Children aged 1-3 years (Group A) were given to drink 1.0 mg/kg of intravenous solution of midazolam mixed with honey, children aged 4-6 years (Group B) were given 0.75 mg/kg of same solution and children aged 7-8 years (Group C) received 0.5 mg/kg of same solution upto a maximum of 20 mg of midazolam. Recovery time was calculated from time of removal of LMA in the operating room till the child either responded to verbal commands or a light stimulus. Results: Sedation score of ≤ 4 was considered favourable and was found in 90-96% of patients. Separation score of 1 was considered favourable and was found in 89% of patients in group A, 85% in group B and 84% of patients in group C. Favourable induction score of ≤ 3 was found in 82% of patients in group A, 90% of patients in group B and 85% of patients in group C. The recovery time of < 30 minutes was found in 89% - 95% of patients. Conclusion: Intravenous solution of midazolam mixed with honey provides excellent sedation and good quality of separation from parents with stable emotional state at induction without significant hemodynamic changes. Incidence of serious complications of oral midazolam is low and it does not significantly prolong recovery.

Keywords: Midazolam, Honey, Infraumbilical, Sedation, Separation.