The impact of oral premedication with midazolam on respiratory function in children

von Ungern-Sternberg, Britta S., Erb, Thomas O., Habre, Walid, Sly, Peter D. and Hantos, Zoltan (2009) The impact of oral premedication with midazolam on respiratory function in children. Anesthesia and Analgesia, 108 6: 1771-1776. doi:10.1213/ane.0b013e3181a324c3

Author von Ungern-Sternberg, Britta S.
Erb, Thomas O.
Habre, Walid
Sly, Peter D.
Hantos, Zoltan
Title The impact of oral premedication with midazolam on respiratory function in children
Journal name Anesthesia and Analgesia   Check publisher's open access policy
ISSN 0003-2999
Publication date 2009-06
Sub-type Article (original research)
DOI 10.1213/ane.0b013e3181a324c3
Volume 108
Issue 6
Start page 1771
End page 1776
Total pages 6
Editor Peter J. Davis
Place of publication Baltimore, MD, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
BACKGROUND: Premedication with midazolam is commonly used in children to reduce anxiety and improve cooperation before anesthesia. However, it has the potential to alter respiratory function because of its muscle relaxant properties. We assessed functional residual capacity (FRC), ventilation homogeneity, using a lung clearance index (LCI), and respiratory mechanics in children awake and 20 min after oral premedication with midazolam (0.3 mg/kg).
METHODS: FRC and LCI were measured using a SF6 multibreath washout technique while respiratory resistance and elastance were extracted from the input impedance obtained by forced oscillation technique in 18 children (3-8 yr) before and after oral premedication with midazolam.
RESULTS: Premedication led to a small (6.5%) but statistically significant decrease in group mean FRC from 25.0 (sd 1.4) to 23.4 (1.9) mL/kg and an associated increase in LCI by 7.8% from 6.4 (0.4) to 6.9 (0.4), indicating increased ventilation inhomogeneities. Furthermore, midazolam resulted in a statistically significant increase in respiratory resistance by 7.4% from 3.38 (0.6) to 3.62 (0.6) cm H2O s/L (P < 0.001) and in respiratory elastance by 9.2% from 48.8 to 52.9 cm H2O s/L (P < 0.001). The changes in FRC, LCI, resistance and elastance were significantly correlated (P < 0.001).
CONCLUSIONS: In children with normal lungs, premedication with a relatively small-dose of midazolam led to mild changes in respiratory variables shortly after its administration. However, the anesthesiologist should be aware that using midazolam in children at high risk of respiratory complications under anesthesia might lead to a greater decrease in respiratory function.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 11 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 17 Nov 2010, 11:57:10 EST