COMPARISON OF ORAL MIDAZOLAM WITH ORAL PROMETHAZINE ON DECREASING ANXIETY OF CHILDREN WHEN SEPARATED FROM THEIR PARENTS BEFORE ANESTHESIA

Abstract

BACKGROUND AND OBJECTIVE: Children feel anxious and fear when they are separated from their parents before going to operating room that it may cause some difficulties and behavior changes. The purpose of this study was to compare the effect of oral midazolam and promethazine on decreasing children anxiety when they are separated from their parents before anesthesia.METHODS: This clinical study was performed on 56 children 1-5 years old with ASA class I & II who were candidate for elective surgery. They were divided into two randomized equal groups. First group received midazolam 0.3mg/kg and the second one received promethazine 1mg/kg (both orally), 20-30 minutes before entrance to the operating room. The way the child is separated from his/her parents, hemodynamic changes (heart rate) during entrance to the operating room, before and after induction of anesthesia, nausea and vomiting after surgery, and also the duration of recovery time were evaluated and recorded. FINDINGS: The mean age in midazolam and promethazine group was 36±18.25 and 36±15.86 months, respectively. Child separation from parents in midazolam group was easier than promethazine group (p=0.019). The mean of heart rate in midazolam group before premedication, before anesthesia and after tracheal intubation was 107.96±10.18, 116.18±14.2 and 125.61±16.82, respectively and in promethazine group, it was 104.82±9.4, 118.68±13.73 and 128.96±18.4, respectively. Postoperative nausea and vomiting in both groups did not occur. A short recovery time in midazolam group was 78.6% and in promethazine group was 53.6%.CONCLUSION: The results showed that using oral midazolam is preferred to oral promethazine for children separation (under 5 years) from their parents before general anesthesia.

Keywords

• anxiety
• midazolam
• promethazine