Optimising the oral midazolam dose for premedication in people with intellectual disabilities and/or autism spectrum disorder

IF 2.1 3区医学 Q2 PSYCHOLOGY, EDUCATIONAL

Journal of Applied Research in Intellectual Disabilities Pub Date : 2024-06-11 DOI:10.1111/jar.13265

Hitoshi Higuchi, Kota Miyake, Saki Miyake, Maki Fujimoto, Yukiko Nishioka, Shigeru Maeda, Takuya Miyawaki

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Abstract

Background

In people with intellectual disabilities and/or autism spectrum disorder, oral midazolam (OM) is very effective as premedication for facilitating medical treatment. In this retrospective study, we investigated the optimal dosage of OM for premedication.

Methods

Patients with intellectual disability and/or autism spectrum disorder who were given OM as a premedication were selected from anaesthesia records. The primary outcome variable was the dose of OM (mg/kg) required to produce an adequate sedation.

Results

The mean OM dose required was 0.32 ± 0.10 mg/kg. The required OM dose decreased significantly as age and weight increased, and age and weight were also shown to be significantly associated with the dose of OM in the multivariate linear regression analysis.

Conclusion

The dosage of OM to achieve adequate sedation should decrease as the patient ages. Furthermore, adequate sedation can be achieved with even lower doses of OM in obese people.

Abstract Image

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优化用于智障和/或自闭症谱系障碍患者预处理的咪达唑仑口服剂量。

背景：对于智障人士和/或自闭症谱系障碍患者来说，口服咪达唑仑（OM）是一种非常有效的治疗前用药，有助于接受治疗。在这项回顾性研究中，我们探讨了口服咪达唑仑作为治疗前用药的最佳剂量：方法：我们从麻醉记录中选取了使用 OM 作为术前用药的智障和/或自闭症谱系障碍患者。主要结果变量是产生充分镇静所需的OM剂量（毫克/千克）：结果：所需 OM 的平均剂量为 0.32 ± 0.10 毫克/千克。随着年龄和体重的增加，所需的OM剂量明显减少，在多变量线性回归分析中，年龄和体重与OM剂量也有显著相关性：结论：达到充分镇静的 OM 剂量应随着患者年龄的增长而减少。此外，肥胖者甚至可以使用更低剂量的 OM 达到充分镇静的目的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Research in Intellectual Disabilities Multiple-

CiteScore

4.70

自引率

12.50%

发文量

期刊介绍： JARID is an international, peer-reviewed journal which draws together findings derived from original applied research in intellectual disabilities. The journal is an important forum for the dissemination of ideas to promote valued lifestyles for people with intellectual disabilities. It reports on research from the UK and overseas by authors from all relevant professional disciplines. It is aimed at an international, multi-disciplinary readership. Topics covered include community living, quality of life, challenging behaviour, communication, sexuality, medication, ageing, supported employment, family issues, mental health, physical health, autism, economic issues, social networks, staff stress, staff training, epidemiology and service provision.