Clinical Study The Effects of Single-Dose Rectal Midazolam Application on Postoperative Recovery, Sedation, and Analgesia in Children Given Caudal Anesthesia Plus Bupivacaine Sedat Saylan, 1 Ahmet Eroglu, 2 and Davut Dohman 2 1 Department of Anesthesiology and Reanimation, Kanuni Education and Research Hospital, 61290 Trabzon, Turkey 2 Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey Correspondence should be addressed to Sedat Saylan; sedatsaylan@yahoo.com Received 4 December 2013; Revised 7 March 2014; Accepted 9 April 2014; Published 5 May 2014 Academic Editor: Engin Erturk Copyright © 2014 Sedat Saylan et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. his study aimed to compare the efects of rectal midazolam addition ater applying bupivacaine and caudal anesthesia on postoperative analgesia time, the need for additional analgesics, postoperative recovery, and sedation and to ind out its adverse efects in children having lower abdominal surgery. Methods. 40 children between 2 and 10 years of ASA I-II were randomized, and they received caudal anesthesia under general anesthesia. Patients underwent the application of caudal block in addition to saline and 1 mL/kg bupivacaine 0.25%. In the postoperative period, Group C (n = 20) was given 5 mL saline, and Group M (n = 20) was given 0.30 mg/kg rectal midazolam diluted with 5 mL saline. Sedation scale and postoperative pain scale (CHIPPS) of the patients were evaluated. he patients were observed for their analgesic need, irst analgesic time, and adverse efects for 24 hours. Results. Demographic and hemodynamic data of the two groups did not difer. Postoperative sedation scores in both groups were signiicantly lower compared with the preoperative period. here was no signiicant diference between the groups in terms of sedation and suicient analgesia. Conclusions. We conclude that caudal anesthesia provided suicient analgesia in peroperative and postoperative periods, and rectal midazolam addition did not create any diferences. his trial is registered with ClinicalTrials.gov NCT02127489. 1. Introduction Pediatric patients need good recovery, sedation, and analgesia ater surgery. Comfortable recovery period relaxes children, increases parent satisfaction, and provides doctor easier postoperative monitoring. As caudal analgesia is simple, reliable, and efective in postoperative analgesia, it is widely used in pediatric patients [1–3]. In postoperative period, less agitation and analgesic requirement is reported in children with caudal block ater the induction of general anesthesia. However, postoperative analgesic efect may end early with a single dose of caudal local anesthetic and additional analgesia may be required. Researchers have started to use various drugs alone or in combination with other drugs in a caudal way to ensure efective and long-lasting analgesia. Rectal midazolam is reported to provide good sedation and inhibit agitation in pediatric patients [4, 5]. In this study, a noninvasive application of 0.30 mg/kg rectal midazolam was added to caudal anesthesia providing efective postoperative analgesia. We aimed to ind out the efects of 0.30 mg/kg rectal midazolam addition ater caudal anesthesia with 0.25% bupivacaine on postoperative analgesia time, the need for additional analgesics, postoperative recov- ery, and sedation in children. he adverse efects were also studied. 2. Methods Ater the approval of local ethics committee and informed parental consent, 40 children (ASA physical status I-II; age 2–10 years) scheduled for lower abdominal surgery were ran- domly allocated to two groups of twenty each. Children with signiicant respiratory system, circulatory system, and liver and kidney function disorder and history of allergy to the drugs to be studied, those who received analgesic medication Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 127548, 6 pages http://dx.doi.org/10.1155/2014/127548