Impact of age on efficacy of midazolam oral solution in alleviating preoperative anxiety in pediatric patients
AIM To evaluate the influence of age on the effectiveness of midazolam oral solution in managing preoperative anxiety in pediatric patients.METHODS Pediatric patients,aged 1 to 6 years,scheduled for elective surgery under general anesthesia,regardless of gender,American Society of Anesthesiologists Ⅰ-Ⅱ classification,were divided into two age groups:infants(1 ≤ age≤3 years)and children(3＜age ≤ 6 years).The initial dose of oral midazolam solution administered was 0.5 mg·kg-1.Subsequent dosages were determined using a bias coin design dose-up-and-down sequential method,based on the patient's modified Ramsay sedation score,parental separation anxiety score,and facemask induction score after admission.The behavior scores and adverse reactions during sedation between the two groups were recorded and compared.The 95％effective dose(ED95)and corresponding 95％confidence interval(95％CI)of midazolam oral solution for preoperative anxiety relief in children was calculated through isostatic regression analysis.RESULTS The ED95 for infants and children was 0.83 mg·kg-1(95％CI:0.69 to 0.88 mg·kg-1)and 0.89 mg·kg-1(95％CI:0.69 to 0.97 mg·kg-1),respectively.No statistically significant difference in ED95was observed between the two groups(P＞0.05).A comprehensive analysis of both age groups yielded an overall ED95 of 0.89 mg·kg-1(95％CI:0.79 to 0.97 mg·kg-1)for midazolam oral solution in alleviating preoperative anxiety in children aged 1 to 6 years.There was a statistically significant difference in the behavior scores between the two groups(P＜0.05),but no difference in parental satisfaction(P＞0.05).Adverse events including hypoxemia,respiratory depression,nausea and vomiting were not observed in the two groups during the induction period and the anesthesia recovery period.CONCLUSION The efficacy of midazolam oral solution in alleviating preoperative anxiety in children is not affected by age.The dose of ED95 for relieving preoperative anxiety in children aged 1 to 6 years is 0.89 mg·kg-1.
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