Effect of preoperative application of midazolam oral solution on agitation during awakening after tonsillectomy in children

Abstract

To observe the effect of preoperative application of midazolam oral solution on postoperative agitation during postoperative awakening in children undergoing tonsillectomy proposed to be performed under general anaesthesia. Sixty children who underwent elective tonsil surgery in our hospital from March to July 2023 were selected for the study and were divided into control group and study group using random number table method, 30 cases/group. In the experimental group, midazolam 0.5 mg/kg was administered orally 30 min before surgery, and the same dose of saline was administered orally in the control group. The heart rate and mean arterial pressure of the children in both groups were observed and recorded before the oral administration of the drug (T0), 15 min after the oral administration of the drug (T1), 30 min after the administration of the drug (T2), and after the end of the operation (T3), and the time of awakening, the time of extubation, and the Ricker sedation-agitation scale (SAS). Comparison of HR and MAP levels at the moment of T0 and T1 between the two groups was not statistically significant (P > 0.05); HR and MAP levels at the moment of T2 and T3 in the experimental group were significantly lower than those in the control group, and the difference was statistically significant (P < 0.05); comparison of the time of awakening and extubation time between the two groups was not statistically significant (P > 0.05); the SAS scores of the experimental group and the number of cases in which SAS scores ≤ 5 were significantly lower, and the difference was statistically significant (P < 0.05). The SAS score and the number of cases with SAS score ≤ 5 in the experimental group were significantly reduced, and the difference was statistically significant (P < 0.05). Preoperative oral midazolam 0.5 mg/kg is safe and effective in sedation during paediatric tonsillectomy and reduces agitation scores during awakening from general anaesthesia without affecting awakening time or extubation time.