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British Journal of Anaesthesia, 1986, Vol. 58, No. 10 1104-1108
© 1986 The Board of Management and Trustees of the British Journal of Anaesthesia

other

SEDATION OF CHILDREN REQUIRING ARTIFICIAL VENTILATION USING AN INFUSION OF MIDAZOLAM

P. D. BOOKER, M.B., F.F.A.R.C.S., A. BEECHEY, M.B., F.F.A.R.C.S.* and A. R. LLOYD-THOMAS, M.B., F.F.A.R.C.S.**

Royal Liverpool Children's Hospital Myrtle Street, Liverpool L7 7DG.

Correspondence to P.D.B.

The sedation of 50 children aged 6 months to 9 years who had undergone open heart surgery was studied. During artificial ventilation a midazolam infusion was used in conjunction with the administration of morphine (and tubo-curarine). Sedation for patients breathing spontaneously with positive airway pressure was continued with midazolam alone. The duration of the midazolam infusion (2–6 µig kg–1 min–1) ranged from 12 to 197 h. Forty-seven of the children were sedated uneventfully; the remaining three children needed small doses of other sedative agents. In 10 of the children, blood samples were taken for serum midazolam assay and a short Synacthen test was performed. There was no clinical evidence of accumulation of midazolam, but midazolam concentrations were so variable that no conclusions could be drawn. All patients in whom they were measured (n = 10) had high basal cortisol concentrations, but displayed normal responses to Synacthen.

*Department of Anaesthesia, Queens Medical Centre, Nottingham.

**Department of Anaesthesia, Saint Bartholomew’s Hospital, West Smithfield, London EC1A 7BE.


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