Perbandingan Pemberian Midazolam 0,03 mg/KgBB dan 0,05 mg/KgBB sebagai Anxiolysis terhadap Emergence Delirium pada Pasien Pediatrik dengan General Anesthesia

Abstract

Introduction: One of the primary considerations in performing general anesthesia (GA) in the pediatric population is the potential for postoperative emergence delirium (ED). This condition is characterized by symptoms of agitation or excessive crying, which can directly affect the child's and parents' perception of the procedure. The role of midazolam at certain doses as an anxiolytic agent has gained increasing importance in recent years, given its impact in providing greater 'comfort' for children during the postoperative phase. This study aims to compare different doses of midazolam in pediatric populations as a preventive therapy for ED occurrence. Methods: This randomized controlled trial (RCT) was conducted at Haji Adam Malik General Hospital, Indonesia, comparing midazolam doses of 0.03 vs. 0.05 mg/kgBW in a group of pediatric patients undergoing GA. Anxiety levels were assessed using a modified YPAS questionnaire and PAED score as representative measures of ED occurrence. Statistical analysis was performed using SPSS version 24.0. Results: A total of 60 pediatric patients (70.0% male) with a mean age of 6.67 and 7.70 years in the 0.03 and 0.05 mg/kgBW groups, respectively, were included. There was no significant effect on hemodynamic analysis following midazolam administration. While a strong positive correlation was observed between m-YPAS and PAED scores in this study (r=0.810), there was no significant difference between the two groups regarding the anxiety questionnaire findings (P>0.05), indicating that the effects of both midazolam doses were relatively similar. Additionally, no differences were found in the occurrence of side effects. Conclusion: Midazolam at a dose of 0.03 mg/kgBW has the same clinical benefit as 0.05 mg/kgBW for preventing ED, with no difference in the side effects between the two doses.