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A comparison of oral transmucosal fentanyl and oral midazolam for premedication in children
Author(s) -
Howell T. K.,
Smith S.,
Rushman S. C.,
Walker R. W. M.,
Radivan F.
Publication year - 2002
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2002.02698_4.x
Subject(s) - medicine , midazolam , premedication , anesthesia , fentanyl , placebo , sedation , vomiting , alfentanil , postoperative nausea and vomiting , tonsillectomy , alternative medicine , pathology
Summary Oral transmucosal fentanyl citrate (OTF) was compared with midazolam as a premedicant in a prospective, randomised, placebo‐controlled, double‐blind trial. Eighty children (ASA grade 1or 2, aged 3–9 years) who presented for tonsillectomy were randomly allocated to receive either 2.5 ml OTF (15–20 µg.kg −1 ) in a lollipop format and 0.5 ml.kg −1 placebo syrup, or midazolam syrup (0.5 mg.kg −1 ) and a placebo lollipop (2.5 ml). The acceptability of sedation, anxiety and compliance with anaesthetic induction were assessed. The children were given an ‘emergence’ score for their recovery. Analgesia requirements, the incidence of vomiting, itching and any behavioural changes were assessed for 6 h postoperatively. Oral transmucosal fentanyl citrate was as effective as midazolam in aiding compliance with anaesthesia, but is significantly better in its appeal to children (p < 0.001) and emergence (p < 0.001) characteristics. In conclusion, OTF may be particularly useful as a premedicant in paediatric practice.