Levent KILIÇKAN, Sevim İNDELEN, A. Sıtkı ÖZDAMAR, Kamil TOKER, Dilek ÖZDAMAR

Çocuk ürolojisi minimal cerrahi girişimlerinde oral ve rektal midazolam

Çocuklarda sedasyon eşliğinde minimal cerrahi girişimler daha rahat yapılabilir. Bu amaçla kısa etki süreli değişik yollardan uygulanabilen, bunun yanı sıra cerrahi sonrası amnezi oluşturabilen midazolam en çok tercih edilen ilaçlardandır. Midazolam, bilinçli sedasyonda oral, rektal ve intravenöz, intramüsküler, intranazal gibi yollardan uygulanır. Oral ve rektal uygulamada sedasyon kalitesi, amnezi etkinliği postoperatif davranış bozukluklarına etkisinde bir farklılık olup olmadığını, SpO2 ve vital bulgular üzerindeki etkilerini araştırmak amacıyla çift kör olarak planlanan bu çalışmada rasgele seçilen ASA-I sınıf, yaşları 3-12 yıl arasındaki çocuklardan oral, rektal ve kontrol grubu olmak üzere 15'er olguluk üç grup oluşturuldu. Oral ve rektal gruba 0.5 mg/kg midazolam uygulandı. Kontrol grubuna ise 10-15 mL oral meyve suyu verildi. Sedasyon açısından kontrol grubu, oral ve rektal midazolam uygulanan gruplardan istatistiksel olarak farklıydı (p

The use of oral and rectal midazolam in minor uro-pediatric surgical procedures

For minor surgical procedures in pediatric patients, sedation can be sufficient instead of general anaesthesia. Midazolam can be use for sedation as it has a short-effect period with postoperative amnesia and can be administrated from different routes as intravenously, intramuscularly, rectally, perorally and intranasally. This double-blind study was designed to compare the quality of sedative effects, the effects on postoperative behavior abnormalities and the effects on SpO2 and vital signs of oral versus rectal midazolam administrations in minor surgical procedures. All patients were between 3-12 years old and ASA-I class. Patients were randomized in 3 equal group (control, oral and rectal, n:15). Midazolam was administered perorally and rectally 0.5 mg/kg. Control group received 10-15 mL fruit juice orally. Regarding the sedation levels there was no difference between oral and rectal groups while significant difference was found between control and study groups. A quick respond to drug effect and postoperative amnesia was obtained in the rectal group then the oral group. The rectal administration was well tolerated then the peroral route. We concluded that, the rectally administration of midazolam could be preferred in pediatric minor surgical procedures.

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