Impacto en la calidad de la Inducción anestésica con premedicación en pacientes pediatricos

Abstract

Anesthetic induction in children is one of the biggest challenges for anesthesiologists because this is the most stressful phase of the perioperative period for the pediatric patient. There are different interventions to minimize perioperative ansiety and enhance the compliance of the pediatric patient during the anesthetic induction. Among successful interventions the pharmacologic premedication with midazolam has shown great benefits in pediatric patients. Methodology: A case-control study was conducted in pediatric patients undergoing surgery in Cardioinfantil Foundation between 2011-2014. Through random convenience sample were selected, as case, patients with premedication and control, patients without premedication. The success in induction was measured by the ICC scale, used worldwide. Results: The mean age was 4.9 σ 3.01 years old for cases and 5.02 σ 3.2 years old for controls, they had the same gender distribution, 40.6% female, 59.3% male. The successful in the induction of anesthesia with midazolam showed significant results (OR 7.3 95% CI 4.3 - 12.5 p0,000), also in men (OR 9.44 95% CI 4.5 - 19.8 p0,000) in children under 5 years (OR 10.33 95% CI 5.07 - p0,000 21.04) in patients with surgical history (OR 5.28 95% CI 12.2 - 27.8 p0.000) or history of previous anesthesia (OR 7.9 95% CI 4.4 - 14.4 p0,000). Discussion: Midazolam as a pharmacologic agent used for premedication in pediatric patients have strong successful results therefore should be used in all cases.