Midazolam is better than clonidine in preventing negative postoperative behaviour in children age 2-4

• Background: Up to 30–50% of children subject to general anaesthesia develop negative postoperative behaviour and emotional problems. Children are given sedative premedication in order to avoid preoperative anxiety/distress, get a smooth induction of anaesthesia and hopefully fewer cases of negative postoperative behaviour. The aim of this study was to find out whether premedication with clonidine or midazolam is better at preventing negative postoperative behaviour evaluated by the parent rating instrument: the Post Hospital Behaviour Questionnaire (PHBQ).Materials and methods: A prospective, randomised, blinded study including 116 children 2–7 years of age, ASA I-II who underwent earnose-throat day surgery at Skelleftea Hospital, Sweden. The children were randomized to premedication with either oral clonidine 4 micrograms/kg body weight or oral midazolam 0.5 mg/ kg body weight. The parents were asked to fill in the PHBQ form one week, one month and six months after the surgery. The incidence of negative postoperative behaviour in the two groups was statistically compared with chi-square test.Results: There were postoperative negative behaviours in both groups. Among children aged 2–4 there were significantly more negative behaviours in the clonidine group than in the midazolam group both one week and one month after the surgery. The difference between the two groups did not remain after six months but there were still postoperative negative behaviours in both groups at that time.Conclusion: Oral midazolam is better than oral clonidine in preventing negative postoperative behaviour in children aged 2–4 years, one week and one month after surgery and anaesthesia.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

Publication and Content Type

vet (subject category)

art (subject category)