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Timing of Midazolam in Children Undergoing Adenotonsillectomy: Effects on Stress, Cortisol, and Recovery
Sponsor: Erzurum City Hospital
Summary
This study is a prospective, randomized, controlled clinical trial designed to evaluate the optimal timing of midazolam administration in children undergoing adenotonsillectomy. The study will be conducted at the Departments of Otorhinolaryngology and Anesthesiology of Erzurum City Hospital. Midazolam is commonly used in pediatric patients to reduce anxiety and improve perioperative comfort. However, the optimal timing of its administration (before surgery or during anesthesia induction) remains unclear. This study aims to compare the effects of preoperative oral midazolam and intraoperative intravenous midazolam on stress response, behavioral outcomes, and recovery quality. Participants will be randomly assigned to one of two groups. In Group A, children will receive oral midazolam (0.5 mg/kg) 30 minutes before surgery. In Group B, children will receive intravenous midazolam (0.05-0.1 mg/kg) during anesthesia induction. The primary outcome of the study is the change in serum cortisol levels, which reflects the physiological stress response. Blood samples will be collected twice: once 10 minutes after anesthesia induction and once 15 minutes after surgery in the post-anesthesia care unit. In addition to cortisol levels, the study will assess preoperative anxiety using an observational anxiety scale, postoperative pain using a behavioral pain scoring system, and parental satisfaction using a standardized questionnaire. These measures aim to provide a comprehensive evaluation of the child's perioperative experience. The findings of this study may help determine the most effective timing of midazolam administration to reduce stress, improve recovery, and enhance overall patient and family satisfaction in pediatric surgical care.
Official title: OPTİMİZATİON OF MİDAZOLAM ADMİNİSTRATİON TİMİNG İN PEDİATRİC ADENOTONSİLLECTOMY: EFFECTS ON CORTİSOL RESPONSE, BEHAVİORAL STRESS, AND RECOVERY QUALİTY
Key Details
Gender
All
Age Range
3 Years - 10 Years
Study Type
INTERVENTIONAL
Enrollment
100
Start Date
2026-08-01
Completion Date
2027-09-01
Last Updated
2026-06-03
Healthy Volunteers
No
Interventions
Midazolam (Oral)
Oral midazolam will be administered at a dose of 0.5 mg/kg, 30 minutes before surgery. The medication will be mixed with a small volume of apple juice to facilitate administration.
Midazolam (Intravenous)
Intravenous midazolam will be administered at a dose of 0.05-0.1 mg/kg during anesthesia induction.
Locations (1)
Erzurum City Hospital
Erzurum, Yakutiye, Turkey (Türkiye)