Morphine-midazolam combination dose for presurgical analgesia in children

ABSTRACT

We have examined the use of presurgical morphine-midazolam combination in 80 children aged 2-10 y undergoing repair of hypospadias. They were allocated randomly, in a double-blind study, to receive one of four morphine-midazolam combination doses [n = 20 each]; [group I 76 mg/kg each] [group II 75 mg/kg morphine, 50 mg/kg midazolam]; [group III 50 mg/kg morphine, 75 mg/kg midazolam]; [group IV 50 mg/kg each]. Drugs were given after induction of anesthesia and before the start of surgery. Observational scoring system, using crying, movement, agitation, posture and localization of pain as scoring criteria, was used to assess the children during their stay in the recovery room together with their sedative and/or analgesic requirement. Pre-surgical morphine-midazolam administration produced stable hemodynamic variables with satisfactory postoperative analgesia suggesting 75 mg/kg dose of both morphine and midazolam as upper permissible dose, and 50 mg/kg each as lower effective dose