Since children's intellectual perception is limited, the preoperative visit by an anesthesiologist alone can rarely help to free the small patients from fear and restlessness prior to elective surgery. In order to relieve anxiety which should be the primary goal of premedication in any patient - children need anxiolytic premedication agents. Drugs for premedication administered by intramuscular or rectal route in children often cause pain, fear and discomfort. The present study was performed in order to investigate oral given midazolam in the premedication of children with special regard to the practical suitability of this method. 100 children, 0.5 to 10 years of age (group A: 0.5-4 years, group B: 5-10 years) undergoing elective urological surgery received 0.4 mg/kg midazolam orally about 20 minutes prior to the arrival in the operation unit. After insertion of a venous cannula into a forearm vein anesthesia was induced with thiopental and maintained by inhalation with Isoflurane, nitrous oxide and oxygen (fi O2:0.3). Degree of sedation, state of mind and behaviour (for 100 children) as well as blood pressure and heart rate (separately for group A and B) were registered preoperatively at defined, comparable and representative circumstances. Side effects prior and during induction phase of anesthesia were documented. The personal data are representative for a normal population of children with typical urological diseases. Oral administered midazolam had only a mild or non sedative effect in 76-84% of the children 70-84% of the small patients showed an indifferent or euphoric state of mind and 67-88% behaved cooperatively or passively.(ABSTRACT TRUNCATED AT 250 WORDS)

Anxiety↗

PubMedDate not supplied

Binding of thiopental to human serum albumin in the presence of halogenated hydrocarbons and ethers.

Thiopental binding (substrate concentration 0.04.10(-3) M = 10 micrograms/ml) to 1% human serum albumin (HSA) studied by equilibrium dialysis in 1/15 M phosphate buffer solution (pH 7.4) was increased significantly from 40.2% (= control) to 55% in the presence of 4.71.10(-3) M halothane (= 11.36 vol%); 1.18.10(-3) M = 2.84 vol% halothane caused a lesser but still significant increase (vs. control) of thiopental binding. This halothane effect on the binding of thiopental to HSA was studied under several experimental conditions (variation of thiopental concentration, HSA concentration, pH of the buffer solution, temperature). Other halogenated hydrocarbons such as chloroform (6.2.10(-3) M) and carbon tetrachloride (5.2.10(-3) M) also markedly increased the binding of thiopental to HSA as compared to the control (percentage of fraction bound, 53 and 61%, respectively); the same effect, but to a lesser extent, was obtained under the influence of three halogenated ethers, i.e., enflurane (4.1.10(-3) M--greater than 45% thiopental bound), isoflurane (4.1.10(-3) M--greater than 50% bound) and methoxyflurane (4.3.10(-3) M--greater than 47% bound). Under the same experimental conditions, ethanol (up to 8.9.10(-2) M) and diethylether (up to 4.9.10(-2) M) did not increase the percentage of thiopental bound to HSA.

Carbon Tetrachloride↗