Similar excitation after sevoflurane anaesthesia in young children given rectal morphine or midazolam as premedication

Abstract

In this study morphine for premedication in young children anaesthetized with sevoflurane was associated with similar postoperative and higher preoperative OPDS scores compared with midazolam. These findings indicate that substitution of morphine for midazolam is no useful way of reducing clinical excitation after sevoflurane anaesthesia.

Comparison between ketamine and fentanyl–droperidol for rectal premedication in children: a randomized placebo controlled trial

“…Oral fentanyl at a dose of 15 lg kg -1 has been reported to cause preoperative vomiting [22], although lower doses seem to be a safe alternative to midazolam [23], despite a higher rate of PONV; other authors [24] have recently confirmed that oral fentanyl can reduce early postoperative agitation but increases both PONV and recovery times, thus limiting its clinical usefulness. Rectal morphine, when compared to midazolam, shows similar postoperative and higher preoperative discomfort and is not advisable as an alternative to midazolam [25]. Bibliographic data regarding the rectal administration of fentanyl are lacking; nevertheless, it is possible to suggest some hypotheses.…”