Comparison of oral triclofos, diazepam and flunitrazepam as premedicants in children undergoing otolaryngological surgery

Abstract

Triclofos 70 mg kg-1, diazepam 0.25 mg kg-1 and flunitrazepam 0.02 mg kg-1 all in combination with atropine 0.03 mg kg-1 were compared as oral premedicants in 128 children undergoing otolaryngological surgery in a double-blind study. All drugs provided good anxiolysis in children 5 yr and older. In children less than 5 yr, the effects of triclofos were superior to those of diazepam and flunitrazepam. There was a positive correlation between anxiolysis and the ease of induction of anaesthesia. In both age groups, flunitrazepam prevented the fasciculations caused by suxamethonium more effectively than did diazepam or triclofos. The preinduction heart rate after triclofos was greater than after the other drugs and its antisialagogue effect was superior. The mean volume of gastric contents was 0.4 ml kg-1 for all the patients with no statistically significant difference between the groups. The mean pH of gastric contents was 4.5 after triclofos and 2.2 after other drugs. The serum concentration of both benzodiazepines in the older age group was greater than in the younger age group.