@misc{10818/59845,
year = {2023},
url = {http://hdl.handle.net/10818/59845},
abstract = {Introduction: Pediatric postoperative delirium is a frequent complication for which preventive pharmacological measures have been suggested. The use of midazolam as a prophylactic strategy has not yet been thoroughly assessed. Notwithstanding the fact that it is used in pediatric presurgical separation anxiety, its role in delirium is yet to be established. Objective: To quantify the incidence of pediatric postoperative delirium in patients undergoing low risk surgical interventions, exposed to oral midazolam-based premedication and to explore the protective and risk factors associated with the development of delirium. Methods: Prospective, analytical observational study with a cohort design. Children were conveniently selected in accordance with the daily list of surgical procedures in the operating rooms. The inclusion criteria were children between 2 and 10 years old, ASA I-II, undergoing low risk surgeries. Concurrent and longitudinal follow-up was then conducted upon admission to the postanesthesia care unit (PACU) for the first hour. Results: A total of 518 children were included. The overall incidence of delirium was 14.4 % (95 % CI: 11.4 %-17.5 %). In the subgroup exposed to midazolam, 178 children were analyzed, with an incidence of delirium of 16.2% (95% CI of 10,8 %-21,7). These patients exhibited a higher tendency to delirium with the use of sevoflurane or fentanyl, and/or when presenting with severe postoperative pain. Patients exposed to propofol and/or remifentanil showed lower incidences. Conclusions: No reduction in the incidence of emergency pediatric delirium associated with the use of pre-surgical oral midazolam in low risk surgical procedures. Prospective controlled trials and additional research are required to study the effectiveness and safety of this intervention. Copyright © 2022 Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.).},
publisher = {Colombian Journal of Anesthesiology},
title = {Premedication with midazolam in low-risk surgery in children does not reduce postoperative delirium. Prospective cohort study},
title = {La premedicación con midazolam en cirugías de bajo riesgo quirúrgico en niños no reduce el delirio posoperatorio. Estudio de cohorte prospectivo},
doi = {10.5554/22562087.e1055},
author = {Cárdenas V.H.G. and Ávila D.S.B. and Barajas W.J.G. and Reina M.A.T. and Villazón I.L.P. and Pulgarín J.L.C. and Díaz W.S.D. and Martínez I.A.},
}