DOI: 10.36347/sjams.2020.v08i09.012

Pages: 2033-2038

Objective: The Objective of the study was to evaluate the quality and cost-effectiveness of inhalation anaesthesia by sevoflurane using midazolam as premedication compared to using sevoflurane alone in paediatric patients. Method: This double blinded randomized clinical trial was conducted among 120 patients aged 1-7 years undergoing routine elective paediatric day case surgery of under 60 minutes of duration at the Department of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU, Dhaka during the period of May 2018 to september 2018. Results: During the study, the patients were randomly allocated into two equal groups–Group A (60 patients) and Group B (60 patients). The children of the experimental group (Group B) received orange juice containing 0.5mg/kg of oral midazolam. Perioperative blood pressure and heart rate were measured by standard monitors and recorded periodically. Induction of both groups was done by inhalation of 4% sevoflurane with fresh gas flow. Recovery profile of patients was measured by Modified Ramsay Sedation Score to observe any emergence of anaesthesia. Mean age of group A and group B patients were 3.76±1.21 and 4.06±1.32 SD (years) respectively, with male predominance (male 92.5% vs female 7.5%). In terms of parent separation characteristics group B were more comfortable (76.7% vs 11.7%) than group A and this finding was significant (p<0.001). Haemodynamic stability of patients were significantly higher in sevoflurane + midazolam group (group B) than group A (p<0.001), sevoflurane consumption rate and the cost of anaesthetic agent were observed between two groups and reduced consumption rate observed in group B and significantly reduced cost of sevoflurane observed in group B (p<0.001). Midazolam premedication with sevoflurane used in Paediatric day surgery may improve the quality of anaesthesia as they had lower incidence of difficult parent separation, makes the patients hemodynamically more stable and lower the incidence.......