Advanced

Similar excitation after sevoflurane anaesthesia in young children given rectal morphine or midazolam as premedication.

Malmgren, W and Åkeson, Jonas LU (2004) In Acta Anaesthesiologica Scandinavica 48(10). p.1277-1282
Abstract
Background: Sevoflurane is a rapid-acting volatile anaesthetic agent frequently used in paediatric anaesthesia despite transient postoperative symptoms of cerebral excitation, particularly in preschool children. This randomised and investigator-blinded study was designed to evaluate whether premedication with an opioid might reduce non-divertible postoperative excitation more than premedication with a benzodiazepine in preschool children anaesthetized with sevoflurane.



Methods: Ninety-two healthy two to six year-old children scheduled for nasal adenoidectomy were randomised to be given rectal atropine 0.02 mg kg-1 together with either morphine 0.15 mg kg-1 or midazolam 0.30 mg kg-1 approximately 30 min before induction... (More)
Background: Sevoflurane is a rapid-acting volatile anaesthetic agent frequently used in paediatric anaesthesia despite transient postoperative symptoms of cerebral excitation, particularly in preschool children. This randomised and investigator-blinded study was designed to evaluate whether premedication with an opioid might reduce non-divertible postoperative excitation more than premedication with a benzodiazepine in preschool children anaesthetized with sevoflurane.



Methods: Ninety-two healthy two to six year-old children scheduled for nasal adenoidectomy were randomised to be given rectal atropine 0.02 mg kg-1 together with either morphine 0.15 mg kg-1 or midazolam 0.30 mg kg-1 approximately 30 min before induction and maintenance of sevoflurane anaesthesia. The patient groups were compared pre- and postoperatively by repeated clinical assessments of cerebral excitation according to a modified Objective Pain Discomfort Scale, OPDS.



Results: There were no statistically significant postoperative differences in incidence, extent or duration of excitation between children given morphine or midazolam for premedication, whereas morphine was associated with more preoperative excitation than was midazolam. The study groups did not differ significantly with respect to age, weight, duration of surgery and anaesthesia, and time from tracheal extubation to arrival in and discharge from the postoperative ward.



Conclusion: In this study morphine for premedication in young children anaesthetized with sevoflurane was associated with similar postoperative and higher preoperative OPDS scores compared with midazolam. These findings indicate that substitution of morphine for midazolam is no useful way of reducing clinical excitation after sevoflurane anaesthesia. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
48
issue
10
pages
1277 - 1282
publisher
Wiley-Blackwell
external identifiers
  • pmid:15504188
  • wos:000224727100010
  • scopus:8544282428
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2004.00528.x
language
English
LU publication?
yes
id
6fbfe8ef-73ab-4801-ba1c-c9bb7f466075 (old id 129697)
date added to LUP
2007-07-26 10:46:15
date last changed
2017-10-01 03:51:47
@article{6fbfe8ef-73ab-4801-ba1c-c9bb7f466075,
  abstract     = {Background: Sevoflurane is a rapid-acting volatile anaesthetic agent frequently used in paediatric anaesthesia despite transient postoperative symptoms of cerebral excitation, particularly in preschool children. This randomised and investigator-blinded study was designed to evaluate whether premedication with an opioid might reduce non-divertible postoperative excitation more than premedication with a benzodiazepine in preschool children anaesthetized with sevoflurane.<br/><br>
<br/><br>
Methods: Ninety-two healthy two to six year-old children scheduled for nasal adenoidectomy were randomised to be given rectal atropine 0.02 mg kg-1 together with either morphine 0.15 mg kg-1 or midazolam 0.30 mg kg-1 approximately 30 min before induction and maintenance of sevoflurane anaesthesia. The patient groups were compared pre- and postoperatively by repeated clinical assessments of cerebral excitation according to a modified Objective Pain Discomfort Scale, OPDS.<br/><br>
<br/><br>
Results: There were no statistically significant postoperative differences in incidence, extent or duration of excitation between children given morphine or midazolam for premedication, whereas morphine was associated with more preoperative excitation than was midazolam. The study groups did not differ significantly with respect to age, weight, duration of surgery and anaesthesia, and time from tracheal extubation to arrival in and discharge from the postoperative ward.<br/><br>
<br/><br>
Conclusion: In this study morphine for premedication in young children anaesthetized with sevoflurane was associated with similar postoperative and higher preoperative OPDS scores compared with midazolam. These findings indicate that substitution of morphine for midazolam is no useful way of reducing clinical excitation after sevoflurane anaesthesia.},
  author       = {Malmgren, W and Åkeson, Jonas},
  issn         = {0001-5172},
  language     = {eng},
  number       = {10},
  pages        = {1277--1282},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Similar excitation after sevoflurane anaesthesia in young children given rectal morphine or midazolam as premedication.},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2004.00528.x},
  volume       = {48},
  year         = {2004},
}