Comparison of Intranasal Dexmedetomidine and Oral Midazolam for Premedication in Pediatric Anaesthesia - A Randomized Controlled Trial
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 2
Abstract
Introduction: Minimizing distress for children in the operating room (OR) environment and to facilitate a smooth induction of anaesthesia is one of the challenges for pediatric anesthesiologists. Midazolam is the most commonly used drug. Dexmedetomidine (22) is a newer α2-agonist with a more selective action on the α 2-adrenoceptor and a shorter half-life. Its bioavailability is 81.8% (72.6-92.1%) when administered via the buccal mucosa. Our aim of the study was primarily to compare the efficacy of intranasal dexmedetomidine and oral midazolam for preoperative anxiolysis and sedation in children before induction of anaesthesia and Secondary objective was to compare the hemodynamic changes-Systolic blood pressure and heart rate changes, wake-up behavior, time until ready for discharge from the PACU between the two groups. Materials and Methods: Study was conducted at the Department of Pediatric Surgery and Department of Anesthesiology, SAT hospital Thiruvananthapuram during the period 2014 - 2015.Inclusion criteria : ASAI & 11, Children in the age group 4-12years, Duration of surgery < 2hrs, Elective surgery were included. Exclusion Criteria: Allergy or hypersensitive reaction to dexmedetomidine or midazolam, ASA III & IV, Age < 4years, Full stomach, Duration of surgery > 2hrs, Emergency surgery were excluded. Patients were divided into those receiving intranasal dexmedetomidine and those receiving oral midazolam. Children are randomly allocated to one of the two groups. Observation and Results: Children premedicated with 1 µg /kg of intranasal dexmedetomidine attained more significant and satisfactory sedation at parental separation and at induction of anaesthesia than those patients who received oral midazolam. Conclusion: In this study, we have shown that 1 ng/kg intranasal dexmedetomidine is another technique for producing sedation in children and it causes no discomfort during administration. Intranasal drug administration is relatively quick, simple, and may have benefits over transmucosal routes or rectal administration, which requires more patient cooperation.
Authors and Affiliations
Jamuna Rani J
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