Use of self-made midazolam mixtures in preoperative sedation of children undergoing oral surgery under general anesthesia: a prospective, randomized, control study

Objective: Pediatric patients have high tendency of anxiety and tension before going to operating room and till they are anesthetized. So they usually need to be well-sedated before shifting to the operating room. We investigated the use of self-made midazolam mixture for preoperative sedation in children before oral treatment under general anesthesia. Methods: A total of 64 children who received intra-oral surgery under general anesthesia from January 2021 to June 2021 in the Department of Pediatric Stomatology of Yantai Stomatology Hospital were randomly divided into two groups; Group A (n = 32) received 0.5 mg/kg midazolam solution mixed with 50% glucose injection. Group B (n = 32) received 0.5 mg/kg midazolam solution mixed with jasmine honey tea. Both solutions were 10 ml mixture and the children were instructed to take it. After 30 min, Ramsay score, oral drug compliance score, oral drug success rate, any adverse reactions, PSAS score, and venipuncture compliance score were noted. Adverse reactions were also recorded at 24 h post-operatively in both groups. Results: Oral success rate (87.5%) in Group A was higher compared to Group B (65.6%) and the difference was statistically significant (P < 0.05). Children in Group A had higher drug oral compliance compared with Group B (P < 0.05). The number of children in Group B had more bitter mouth and nausea after oral medication than in Group A, and the difference was statistically significant (P < 0.05). There were no significant differences in Ramsay scores, PSAS scores, venipuncture compliance scores, and postoperative adverse effects in the two groups (P > 0.05). Conclusion: The mixed solution of midazolam and 50% glucose injection (Group A) was associated with a higher oral success rate, good oral compliance and venipuncture compliance, and less adverse reactions after oral administration. The Ramsay score, PSAS score and postoperative adverse reactions of children were equivalent to those of oral midazolam injection, which could provide reference for clinical use.