Asunto(s)
Aneurisma Coronario , Fístula , Fístula Vascular , Humanos , Aneurisma Coronario/complicaciones , Aneurisma Coronario/diagnóstico , Aneurisma Coronario/cirugía , Fístula/complicaciones , Fístula/diagnóstico , Ventrículos Cardíacos/diagnóstico por imagen , Corazón , Vasos Coronarios , Angiografía Coronaria , Fístula Vascular/complicaciones , Fístula Vascular/diagnósticoAsunto(s)
Neoplasias Cerebelosas/cirugía , Intubación Intratraqueal/métodos , Procedimientos Neuroquirúrgicos/métodos , Choque/etiología , Enfermedad Aguda , Adulto , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Análisis de los Gases de la Sangre/métodos , Presión Sanguínea , Parálisis Bulbar Progresiva/complicaciones , Parálisis Bulbar Progresiva/diagnóstico , Humanos , Hipotensión/etiología , Masculino , Recurrencia , TraqueotomíaRESUMEN
BACKGROUND: The purpose of this study was to determine whether oral midazolam 1.5 mg x kg(-1) is a safe and effective alternative to standard-dose midazolam (0.5-1.0 mg x kg(-1)) premedication for infants and children with congenital heart disease. METHODS: A total of 193 infants and children (4 months to 2 years) undergoing cardiovascular surgery were studied. Each patient received 0.5, 1.0, or 1.5 mg x kg(-1) of oral midazolam. The level of sedation was assessed with a 5-point scale and vital signs were measured including blood pressure (BP), heart rate (HR) and oxyhaemoglobin saturation (SpO2) before and after the medication. RESULTS: Infants and children premedicated with oral midazolam 1.5 mg x kg(-1) were better sedated than those with standard-dose midazolam: 4% of infants and children given 1.5 mg x kg(-1) of midazolam became agitated compared with 14% given 1.0 mg x kg(-1) and 26% in those given 0.5 mg x kg(-1). Ninety percentage of infants and children given 1.5 mg x kg(-1) of midazolam achieved satisfactory sedation (calm, drowsy, or asleep) in 30 min, whereas 68% in those given 1.0 mg x kg(-1) and 35% in those given 0.5 mg x kg(-1). Midazolam 1.5 mg x kg(-1) did not cause any statistically significant decrease in BP, HR, or SpO2, although eight infants and children showed > or =20% drop in systolic BP and six infants and children showed >5% drop in SpO2. No 'spelling attacks', seizure-like activity, apnoea, nor laryngospasm were observed in any infants and children during and after the medication. CONCLUSIONS: Oral midazolam 1.5 mg x kg(-1) is excellent for preanaesthetic medication for infants and children undergoing cardiovascular surgery.