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Premedicación en anestesia pediátrica: citrato de fentanilo oral transmucoso frente a midazolam oral

Keywords: oral transmucosal fentanyl citrate (otfc), midazolam, paediatric premedication.

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Abstract:

introduction: the aim of anaesthetic premedication is to reduce anxiety and stress prior to surgery. paediatric patients suffer even more anxiety due to fear of the unknown and the separation from parents. the need to find out a suitable way of administering premedication to paediatric patients without causing any more trauma is a challenge for the anaesthesiologist. objectives: the objective of the current study was to evaluate the efficacy, level of sedation and a way of accepting two different types of premedication for children: oral transmucosal fentanyl citrate (otfc) and oral midazolam dissolved in fruit juice. methods: in this study, 40 children who were going to be subjected to various types of surgery were randomised to receive otfc 10 μg/kg and midazolam 0.3 mg/kg 30 minutes before venipuncture. variables taken into account were: haemoglobin saturation from the beginning of premedication and inside the recovery room, way of accepting, level of sedation, child behaviour after separation from parents, venous puncture and anaesthetic induction, delay in wakening, need of post-surgical analgesia and appearance of secondary effects. results: results were compared using student?s t (p < 0.05) and there were significant differences in favour of the otfc group as far as the way of accepting a venous puncture was concerned. no differences in behaviour were observed after separation from parents and anaesthetic induction. there were no significant differences in haemoglobin saturation or secondary effects between both groups. conclusions: we believe that the use of otfc is safe, effective and a convenient way to premedicate a paediatric population, who will be undergoing a surgical procedure, with a reasonable degree of sedation which makes separation from their parents, venous catheterisation and anaesthetic induction easier.

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