The effect of midazolam premedication on discharge time in pediatric

Department of Pediatric Dentistry
Resident’s Name:Murphy Program: Lutheran Medical Center - Providence
Article title:The effect of midazolam premedication on discharge time in pediatric patients undergoing general anesthesia for dental restorations
Author(s): Jason Horgesheimer, DDS, Charles Pribble, DDS, Ralph Lugo, PharmD
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2001. V 23 No 6 491-494
Major topic: Effects of midazolam on discharge time after GA
Main Purpose: To evaluate the effect of oral premed w/ midazolam on recovery times of children undergoing dental restorations under GA

Overview of method of research:
The records of 106 children were retrospectively reviewed at Primary Children’s Medical Center in Salt Lake City Utah. All patients were ASA I or II. 50 children received .5mg oral midazolam approx. 30 minutes before the procedure. 56 children did not receive any premed. All children were mask inhalation induced with either nitrous, sevoflurane, or halothane. Also, all patients were nasotracheally intubated. Things taken into account in the study were time spent in the OR, post anesthesia care in the PACU, and time spent in the same day surgical suite.

Findings:
Oral midazolam is one of the most common pre-medications used in pediatric anesthesia practices today. It effectively decreases anxiety, produces amnesia, and facilitates anesthetic induction. Theoretically, midazolam has the potential to cause post op sedation and delay recovery from GA. However there is no clear consensus about this in the literature.

In this retrospective study there was no significant difference between the groups with respect to time spent in the OR, PACU, or SDS.
Key points/Summary:
Pre-op midazolam does not delay discharge of children undergoing GA.

Assessment of Article:
Good article. Right to the point. It shows that administering oral midazolam approx 30 min prior to anesthesia induction, the child receives the maximum post op benefit of anxiolysis and amnesia while not delaying discharge.