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Comparison of Intranasal Dexmedetomidine and Midazolam as Premedication in Pediatric Surgical Patients: A
Gayendra Diwan1, Alok Kumar Bharti2, Kapil Rastogi3
1Department of Anesthesiology and Critical Care, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India.
Introduction:
To relieve anxiety and fear is a major concern for pediatric anesthesiologist, and intranasal dexmedetomidine seems to be better alternative to midazolam to provide sedation and allay anxiety in children.
Aims And Objectives:
We compare the sedative effects, anxiety level, successful child-parental separation, and hemodynamic parameters of either intranasal dexmedetomidine or midazolam as a premedication in children undergoing pediatric surgery.
Setting And Design:
This is a prospective, randomized, double-blind study conducted on 60 patients belonging to the American Society of Anesthesiologists Physical Status Classes I and II, undergoing pediatric surgical procedures with the use of intranasal dexmedetomidine and midazolam as premedication.
Materials And Methods:
Sixty children were randomly allocated into two groups of 30 each: dexmedetomidine group received intranasal dexmedetomidine (1 μg.kg-1), and midazolam group received intranasal midazolam (0.2 mg.kg-1), 30 min before induction. The sedation score, anxiety score, and successful child-parent separation were recorded till 30 min of drug administration, and then, the child was taken to the operating room (OR).
Statistical Analysis:
The Statistical Software, namely Statistical Package for the Social Science 17.0, was used for the analysis of the data. A P < 0.05 was considered statistically significant.
Results:
Children premedicated with intranasal dexmedetomidine achieved significantly lower sedation score (P < 0.001), lower anxiety levels (P = 0.001), and easier child-parent separation (P = 0.003) than children who received intranasal midazolam.
Conclusion:
Intranasal dexmedetomidine was associated with lower sedation levels, lower anxiety levels, and easier child-parent separation at the time of transferring patients to the OR than children who received intranasal midazolam.
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