Effect of premedication on hemodynamics and bispectral index in pediatric dental rehabilitation

Objectives: The aim of this study was to evaluate the effects of rectal midazolam premedication

on hemodynamic parameters and Bispectral Index Scale (BIS) values in children undergoing

general anesthesia (GA) for dental rehabilitation.

Materials and Methods: Records of 30 children aged 2 to 7 years were retrieved and divided

into 2 groups. Group 1 received midazolam 0.3mg/kg body weight rectally and group 2

involved children who did not receive any presedative (control). Mean arterial blood pressure

(MAP), heart rate (HR), oxygen saturation (SpO2), and BIS were evaluated for six times; before

laryngoscopy(1); 1 min(2); 5 min(3); 10 min after nasotracheal intubation(4); at the time of

extubation (5) and at the time of recovery(6). Paired t-test was performed to analyze all data.

p<0.05 was defined as statistically significant.

Results: MAP and HR did not differ significantly between both groups before laryngoscopy

(p>0.05) but increased significantly in control group 1 min after intubation (p<0.04). SpO2

was in the normal range in both groups, which was statistically insignificant (p>0.05). The BIS

records of the midazolam group were slightly lower than the control group in general but this

difference was insignificant (p>0.05).

Conclusions: Midazolam premedication prior to GA induction resulted with lower MAP and HR

than the control group 1 minute after intubation whereas it did not alter BIS values remarkably

at all time intervals. Therefore, the midazolam sedation did not produce a significant change in

reducing GA awareness in children undergoing GA for dental rehabilitation.