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Oral premedication with fentanyl may be a safe and effective alternative to oral midazolam

Published online by Cambridge University Press:  11 July 2005

M. Tamura ,
K. Nakamura ,
R. Kitamura ,
S. Kitagawa ,
N. Mori  and
Y. Ueda
M. Tamura
Affiliation:
Osaka Dental University, Department of Anaesthesiology, Osaka, Japan
K. Nakamura
Affiliation:
Kyoto City Hospital, Department of Anaesthesia, Kyoto, Japan
R. Kitamura
Affiliation:
Kyoto City Hospital, Department of Anaesthesia, Kyoto, Japan
S. Kitagawa
Affiliation:
Kyoto City Hospital, Department of Anaesthesia, Kyoto, Japan
N. Mori
Affiliation:
Osaka Dental University, Department of Anaesthesiology, Osaka, Japan
Y. Ueda
Affiliation:
Osaka Dental University, Department of Anaesthesiology, Osaka, Japan
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Extract

Summary

Background and objective: Although midazolam is commonly given orally to infants and small children for premedication, the taste is sometimes unacceptable even when mixed with syrup. We tested the efficacy and safety of oral fentanyl compared with oral midazolam in a randomized open-label study.

Methods: Fifty-one children, aged 12–107 months and weighing 10–25 kg, were randomly assigned to fentanyl or midazolam treatment groups. Midazolam (5 mg) or fentanyl (0.1 mg) was given orally from a small bottle with a small orifice 30 min before transfer to the preoperative holding room. The excitation–sedation conditions of the patients were assessed before and after general anaesthesia.

Results: The preoperative scores did not differ significantly between the two groups. No major complications were observed in either group. Postoperative vomiting occurred in 5 of 27 (18.5%) patients treated with oral fentanyl and in none of 24 of those treated with midazolam.

Conclusions: Oral administration of fentanyl 30 min before entrance to the holding room for an operation from a bottle with a small orifice is a premedication option for children between 1 and 8 yr of age.

Keywords

ADJUVANTS, ANAESTHESIA, fentanyl, midazolamANAESTHESIADRUG THERAPY, premedicationPAEDIATRICS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 6 , June 2003 , pp. 482 - 486
Copyright
© 2003 European Society of Anaesthesiology

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