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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
COSTA, Verônica Vieira da; TORRES, Rafael Villela Silva Derré; ARCI, Érika Carvalho Pires and SARAIVA, Renato Ângelo. Oral midazolam as pre-anesthetic medication in children and teenagers with cerebral palsy: a comparative study on the variations of the bispectral index. Rev. Bras. Anestesiol. [online]. 2009, vol.59, n.1, pp.28-36. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942009000100005.
BACKGROUND AND OBJECTIVES: Midazolam is a benzodiazepine with hypnotic action widely used as pre-anesthetic medication in pediatric anesthesia. Children with cerebral palsy (CP) also benefit from the use of midazolam, but its effects on this group of patients, who present several particularities, including changes at the site of action of midazolam, are still unknown. The objective of this study was to evaluate the effects of midazolam, when used as pre-anesthetic medication, on the bispectral index (EEG-BIS) of patients with cerebral palsy. METHODS: Two groups of patients were evaluated: one group with the diagnosis of CP and the other without central and peripheral nervous system disorders. The EEG-BIS was recorded in the room, the day before the surgery, and at the day of the surgery, 40 minutes after the administration of 0.6 mg.kg-1 of oral midazolam. Patients with a history of paradoxal reaction to midazolam as well as patients in the control group who were using other medications were excluded. RESULTS: Seventy-seven patients of both genders, 4 to 18 years old, participated in this study. Differences in EEG-BIS between both groups were not detected. After the use of midazolam EEG-BIS decreased in both groups with a statistically significant difference in each group. Statistically significant intergroup differences were not observed. CONCLUSIONS: Midazolam, used as pre-anesthetic medication, at a dose of 0.6 mg.kg-1, reduced basal EEG-BIS without characterizing hypnosis and without statistically significant differences between the study groups.
Keywords : MONITORING [bispectral index]; PRE-ANESTHETIC MEDICATION [midazolam]; SURGERY: pediatric.