Effects Of Intranasal Midazolam Spray As Premedication On Epileptiform EEG In Children During Induction With Sevoflurane

Background:Sevoflurane inhalation induction of anesthesia via mask is widely used in pediatric anesthesia,but high concentrations sevoflurane may cause epileptiform EEG activity in childrenPurpose:This trial was performed to evaluate the effects of intranasal midazolam spray as premedication on the incidence of epileptiform EEG activity during induction with sevoflurane in childrenMethods:86 patients(0.5-6yr,ASA Ⅰ-Ⅱ),undergoing elective surgery under general anesthesia,were randomly allocated to two different premedication groups midazolam group and saline group.After intranasal premedication spray in the waiting area,patients were transferred to the operating room.Patients were anesthetized with 8%sevoflurane via face mask.EEGs were continuously recorded during inductionResults:23 patients(53%,DSP30%、PSR37%、PED9%)in midazolam group had epileptiform EEG patterns compared to 29 patient(67%,DSP37%、PSR35%、PED19%)in saline group(P=0.186).The time from start of sevoflurane until loss of consciousness was shorter in midazolam group than saline group,but the difference was not significant(41.6±11.0s vs 44.1±16.1s;P=0.409)Conclusion:0.4mg/kg midazolam intranasal spray before operation cannot reduce the occurrence of epileptiform EEG in children during sevoflurane induction.