Twelve children 1-5 y old were randomly assigned to receive midazolam 0.2 mg.kg-1 either by the intravenous (IV) or intranasal (IN) routes. After IN administration the rapid onset of absorption was observed (tmax 12 min). After both routes of administration the half-life was similar (2.2 h IN and 2.4 h IV). After IN administration the apparent plasma clearance and volume of distribution were about twice as high as after IV administration. The results are consistent with an estimated mean bioavailability of 55%.

The pharmacokinetics of propofol were studied following a single bolus injection (2.5 mg kg-1) in 10 healthy children (4-7 yr). Propofol was distributed rapidly and extensively (Vss 10.9 (1.2) litre kg-1) and cleared rapidly from the body (Cl 30.6 (2.9) ml min-1 kg-1). With the exception of a larger central compartment volume (V alpha 722 (113) ml kg-1), these data are similar to those reported for young adults who received an identical dose and who underwent sampling over the same period. The larger value of V alpha is consistent with the higher induction dose requirement reported for children.

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Summa yPeri-operative blood glucose, total protein, and electrolytes values were measured in children (3-120 months) scheduled for minor surgery and randomly assigned to three groups according to the type of fluids administered during anaesthesia: chiidren of RL group (n = 27) received lactated Ringer, those of RLDl group (n = 25), 1% dextrose in lactated Ringer, and those in RLD2.5 group (n = 27), 2.5% dextrose in 0.4 N saline (50% D5,50% RL) (63 mmol.l-'). Infusion rate was set according to children's age and weight. Fluids were infused throughout the study with volumetric infusion pumps. Blood samples were obtained at induction (TO), at the end of surgery (Tl), 30 and 60 min later (T2, T3). Pre-operative blood values were within the normal ranges except for high total protein values in all groups of children and for asymptomatic hypoglycaemia (2.3 and 2.5 mmol-1-1) in two children. Blood glucose increased significantly in the three groups post-operatively (P < 0.001), and this increase was related to the amount of glucose infused. Glucose values differed significantly between groups at T1 and T2, while blood glucose values were back to the normal ranges at T2 and T3 in the RL group. Sodium values remained unchanged post-operatively in both RL and RLDl groups, while a sigruficant decrease was observed in the RLD2.5 group (P < 0.001). Total protein decreased in the three groups postoperatively (P < 0.001) towards normal values. These data suggest that RLDl is appropriate for pen-operative fluid therapy in children. Its administration at the infusion rate used in this study, resulted in moderate post-operative hyperglycaemia while avoiding the risk of pen-operative hypoglycaemia, maintaining a constant extracellular fluid composition and correcting preoperative fluid deficit.

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