Effect of age factor on preoperative sedative potency of midazolam oral solution in pediatric patients with inguinal hernia undergoing high ligation of hernial sac
Effect of age factor on preoperative sedative potency of midazolam oral solution in pediatric patients with inguinal hernia undergoing high ligation of hernial sac
Objective To evaluate the effect of age factor on preoperative sedative potency of mid-azolam oral solution in pediatric patients with inguinal hernia undergoing high ligation of the hernial sac.Methods This was a prospective study.American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ pediatric patients of either sex with inguinal hernia,aged 1-6 yr,with preoperative Parental Separa-tion Anxiety Scale score≥3,undergoing elective laparoscopic high ligation of the hernia sac with general anesthesia,were divided into group A(1 yr≤age＜4 yr)and group B(4 yr≤age≤6 yr)based on age.The trial was performed using a sequential method,with an initial midazolam oral solution set at 0.50 mg/kg.If the response was positive,the dose was increased by 0.05 mg/kg in the next patient,or con-versely if negative,the dose was decreased by 0.05 mg/kg in the next patient.The child who preceded the one that exhibited a positive response served as the first case,and this process was repeated until 7 turning points were reached.A positive response was defined as a PSAS score of ≥3 measured at 30 min after oral administration of midazolam oral solution.The probit method was used to calculate the median-effective dose(ED50)and 95％confidence interval(CI)of midazolam oral solution for preoperative sedation in pediatric patients with inguinal hernia undergoing high ligation of the hernial sac in both groups.Results A total of 49 children were ultimately included in this study,with 24 in group A and 25 in group B.The ED50 of mid-azolam oral solution for preoperative sedation was 0.628 mg/kg(95％CI 0.614-0.643 mg/kg)in group A and 0.385 mg/kg(95％CI 0.361-0.412 mg/kg)in group B.The ED50 was significantly higher in group A than in group B(P≤0.05).Conclusions The potency of midazolam oral solution for preoperative sedation in pediatric patients aged 4-6 yr is superior to that in pediatric patients aged 1-＜4 yr with inguinal hernia undergoing high ligation of the hernial sac.
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