Affiliation

• ¹Institute for Anesthesia and Intensive Care Medicine, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
• ²Department of Anesthesia and Perioperative Care, University of California, San Francisco, USA
• ³Institute of Clinical Chemistry, University Hospital of Zurich, Zurich, Switzerland
• ⁴Department of Laboratory Medicine, Hospital Thurgau, Frauenfeld, Switzerland

Corresponding Author

Alexander Dullenkopf, Institute for Anesthesia and Intensive Care Medicine, Kantonsspital Frauenfeld, Pfaffenholzstr 4, CH-8501 Frauenfeld, Switzerland, E-mail: alexander.dullenkopf@stgag.ch

Citation

Dullenkopf, A., et al. Midazolam Plasma Concentrations in Children after Anesthetic Premedication for Short Routine Cases - An Observational Study. (2017) J Anesth Surg 4(2): 145- 149.

Copy rights

© 2017 Dullenkopf, A. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.

Keywords

Abstract

Introduction: Midazolam is commonly used in pediatric patients as a sedative and anxiolytic before the induction of anesthesia. Little is known about clinically resulting plasma levels in the setting of short procedures. Aim of this study was to compare plasma levels of Midazolam at the end of intervention with the corresponding levels at the time point of anesthesia induction for short procedures. The hypothesis was that a certain percentage of patients have higher levels at the end of the procedure.
Method: Twenty pediatric patients between the age of 2 and 8 years, scheduled for short (< 30 minutes) surgical procedures requiring general anesthesia were prospectively enrolled. They all received 0.5 mg/kg Midazolam rectally (maximum dose 10 mg) 30 minutes before transport to the operating room. After induction of the general anesthetic, a first blood sample was obtained, and plasma midazolam levels were determined. A second sample was collected at the end of the procedure.
Results: Three patients had to be excluded from the study, because no midazolam plasma levels were detectable. Midazolam plasma levels were 0.38 ± 0.19 μmol/l in the first blood samples, and 0.2 ± 0.12 μ mol/l at the second time point. In three patients (17.6 %), the midazolam plasma level was higher at the end of the procedure than at the induction of anesthesia.
Conclusion: A considerable percentage of patients displayed a higher plasma level of Midazolam at the end of the procedure (compared to the moment of anesthesia induction). This may have implications for the post-operative period.