Effect of premedication with oral midazolam on preoperative anxiety in children with history of previous surgery - A prospective study

Background and Aims: History of previous surgery may be a risk factor for high preoperative anxiety. The most commonly used technique to reduce preoperative anxiety is oral midazolam premedication because of its safety profile. The aim of this study was to compare the anxiety after premedication in children with a history of previous surgery and those without a history of previous surgery. Methods: A prospective study was conducted in children aged 4-10 years scheduled for surgery under general anaesthesia. Thirty-five children with a history of previous surgery and 35 children without any history of previous surgery were enrolled. Anxiety was assessed using modified Yale Preoperative Anxiety Scale (mYPAS) before and 20 min after premedication with oral midazolam. Anxiety during parental separation and mask acceptance during induction of anaesthesia was assessed using 4-point scale. mYPAS scores were compared using Mann-Whitney U-test, and the incidence of satisfactory parental separation and mask acceptance was compared using chi(2) test. Results: The median (interquartile range) anxiety scores after premedication were statistically similar (P = 0.74) in children without a history of previous surgery [31.7 (23.3-40.8)] and in those with a history of previous surgery [33.3 (28.3-47.5)]. Baseline anxiety scores were comparable in the two groups. A high percentage of children in both the groups had a satisfactory parental separation and mask acceptance score. Conclusion: Anxiety scores after premedication with midazolam were similar in children with history of previous anaesthesia exposure and those experiencing anaesthesia for the first time.