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A comparison of intranasal dexmedetomidine and oral midazolam for premedication in pediatric anesthesia: a double-blinded randomized controlled trial.

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A comparison of intranasal dexmedetomidine and oral midazolam for premedication in pediatric anesthesia: a double-blinded randomized controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Yuen, Vivian M. Hui, Theresa W. Irwin, Michael G. Yuen, Man K.
Description	Country affiliation: Hong Kong Author Affiliation: Yuen VM ( Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong. vtang131@hku.hk)
Abstract	BACKGROUND: Midazolam is the most commonly used premedication in children. It has been shown to be more effective than parental presence or placebo in reducing anxiety and improving compliance at induction of anesthesia. Clonidine, an alpha(2) agonist, has been suggested as an alternative. Dexmedetomidine is a more alpha(2) selective drug with more favorable pharmacokinetic properties than clonidine. We designed this prospective, randomized, double-blind, controlled trial to evaluate whether intranasal dexmedetomidine is as effective as oral midazolam for premedication in children. METHODS: Ninety-six children of ASA physical status I or II scheduled for elective minor surgery were randomly assigned to one of three groups. Group M received midazolam 0.5 mg/kg in acetaminophen syrup and intranasal placebo. Group D0.5 and Group D1 received intranasal dexmedetomidine 0.5 or 1 microg/kg, respectively, and acetaminophen syrup. Patients' sedation status, behavior scores, blood pressure, heart rate, and oxygen saturation were recorded by an observer until induction of anesthesia. Recovery characteristics were also recorded. RESULTS: There were no significant differences in parental separation acceptance, behavior score at induction and wake-up behavior score. When compared with group M, patients in group D0.5 and D1 were significantly more sedated when they were separated from their parents (P < 0.001). Patients from group D1 were significantly more sedated at induction of anesthesia when compared with group M (P = 0.016). CONCLUSIONS: Intranasal dexmedetomidine produces more sedation than oral midazolam, but with similar and acceptable cooperation.
File Format	HTM / HTML
ISSN	00032999
Issue Number	6
Volume Number	106
e-ISSN	15267598
Journal	Anesthesia & Analgesia
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Adrenergic Alpha-agonists Administration & Dosage Child Behavior Drug Effects Consciousness Dexmedetomidine Hypnotics And Sedatives Midazolam Preanesthetic Medication Administration, Intranasal Administration, Oral Anxiety, Separation Prevention & Control Child Child, Preschool Double-blind Method Female Hemodynamics Humans Male Patient Compliance Prospective Studies Research Design Respiration Time Factors Treatment Outcome Comparative Study Journal Article Randomized Controlled Trial
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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