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Objective <p>This study aimed to evaluate the effects of oral midazolam on preoperative sedation and emergence delirium (ED) in pediatric patients undergoing tonsillectomy and adenoidectomy.</p> Methods <p>In this prospective, double-blind study, 80 children (6–12 years) scheduled for surgery between January and December 2024 were randomized into a control group and an observation group (n = 40 each). The control group received oral glucose (0.25 ml/kg) before anesthesia; the observation group received oral midazolam (0.25 ml/kg) 20 min prior. Heart rate, SpO₂, Ramsay sedation score, and Parent Separation Anxiety Scale (PSAS) score were measured before medication and upon entry to the operating room. Cooperation, sleep onset time, extubation time, awakening time, and PACU stay were recorded. FLACC pain scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were assessed at awakening, 5 min after awakening, and on PACU arrival.</p> Results <p>The observation group had a higher rate of perfect induction (ICC = 0) and lower emergence agitation incidence than controls (<i>P</i> &lt; 0.05). PAED and FLACC scores were lower at all emergence time points. Ramsay scores were higher and PSAS scores lower on entry in the observation group, with significant intra-group changes from baseline (<i>P</i> &lt; 0.05). No differences were found in pre-medication or entry heart rate and SpO₂. Extubation, awakening, and PACU times were longer in the observation group (<i>P</i> &lt; 0.05). Adverse event rates did not differ significantly.</p> Conclusion <p>Preoperative oral midazolam improves induction compliance and reduces ED in pediatric tonsillectomy and adenoidectomy, though it prolongs recovery times.</p>

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Application of oral midazolam for preoperative sedation in pediatric tonsillectomy and adenoidectomy and its effects on emergence delirium

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Peikun Han,
  • Lihua Fan,
  • Fuxue Tang

摘要

Objective

This study aimed to evaluate the effects of oral midazolam on preoperative sedation and emergence delirium (ED) in pediatric patients undergoing tonsillectomy and adenoidectomy.

Methods

In this prospective, double-blind study, 80 children (6–12 years) scheduled for surgery between January and December 2024 were randomized into a control group and an observation group (n = 40 each). The control group received oral glucose (0.25 ml/kg) before anesthesia; the observation group received oral midazolam (0.25 ml/kg) 20 min prior. Heart rate, SpO₂, Ramsay sedation score, and Parent Separation Anxiety Scale (PSAS) score were measured before medication and upon entry to the operating room. Cooperation, sleep onset time, extubation time, awakening time, and PACU stay were recorded. FLACC pain scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were assessed at awakening, 5 min after awakening, and on PACU arrival.

Results

The observation group had a higher rate of perfect induction (ICC = 0) and lower emergence agitation incidence than controls (P < 0.05). PAED and FLACC scores were lower at all emergence time points. Ramsay scores were higher and PSAS scores lower on entry in the observation group, with significant intra-group changes from baseline (P < 0.05). No differences were found in pre-medication or entry heart rate and SpO₂. Extubation, awakening, and PACU times were longer in the observation group (P < 0.05). Adverse event rates did not differ significantly.

Conclusion

Preoperative oral midazolam improves induction compliance and reduces ED in pediatric tonsillectomy and adenoidectomy, though it prolongs recovery times.