Subject(s)
Humans , Male , Coronary Aneurysm , Arrhythmias, Cardiac , Respiratory Tract Fistula , Heart Ventricles , Echocardiography , Inpatients , Physical Examination , Cardiology , Heart DiseasesSubject(s)
Coronary Aneurysm , Fistula , Vascular Fistula , Humans , Coronary Aneurysm/complications , Coronary Aneurysm/diagnosis , Coronary Aneurysm/surgery , Fistula/complications , Fistula/diagnosis , Heart Ventricles/diagnostic imaging , Heart , Coronary Vessels , Coronary Angiography , Vascular Fistula/complications , Vascular Fistula/diagnosisSubject(s)
Cerebellar Neoplasms/surgery , Intubation, Intratracheal/methods , Neurosurgical Procedures/methods , Shock/etiology , Acute Disease , Adult , Airway Obstruction/etiology , Airway Obstruction/surgery , Blood Gas Analysis/methods , Blood Pressure , Bulbar Palsy, Progressive/complications , Bulbar Palsy, Progressive/diagnosis , Humans , Hypotension/etiology , Male , Recurrence , TracheotomyABSTRACT
BACKGROUND: The purpose of this study was to determine whether oral midazolam 1.5 mg x kg(-1) is a safe and effective alternative to standard-dose midazolam (0.5-1.0 mg x kg(-1)) premedication for infants and children with congenital heart disease. METHODS: A total of 193 infants and children (4 months to 2 years) undergoing cardiovascular surgery were studied. Each patient received 0.5, 1.0, or 1.5 mg x kg(-1) of oral midazolam. The level of sedation was assessed with a 5-point scale and vital signs were measured including blood pressure (BP), heart rate (HR) and oxyhaemoglobin saturation (SpO2) before and after the medication. RESULTS: Infants and children premedicated with oral midazolam 1.5 mg x kg(-1) were better sedated than those with standard-dose midazolam: 4% of infants and children given 1.5 mg x kg(-1) of midazolam became agitated compared with 14% given 1.0 mg x kg(-1) and 26% in those given 0.5 mg x kg(-1). Ninety percentage of infants and children given 1.5 mg x kg(-1) of midazolam achieved satisfactory sedation (calm, drowsy, or asleep) in 30 min, whereas 68% in those given 1.0 mg x kg(-1) and 35% in those given 0.5 mg x kg(-1). Midazolam 1.5 mg x kg(-1) did not cause any statistically significant decrease in BP, HR, or SpO2, although eight infants and children showed > or =20% drop in systolic BP and six infants and children showed >5% drop in SpO2. No 'spelling attacks', seizure-like activity, apnoea, nor laryngospasm were observed in any infants and children during and after the medication. CONCLUSIONS: Oral midazolam 1.5 mg x kg(-1) is excellent for preanaesthetic medication for infants and children undergoing cardiovascular surgery.
