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Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group
BACKGROUND & OBJECTIVES: Intranasal midazolam-fentanyl is commonly used as pre-medication in paediatric patients, but there is a risk of respiratory depression with this combination. Dexmedetomidine is a drug that preserves respiratory function. The objective of this study was to compare the eff...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284369/ https://www.ncbi.nlm.nih.gov/pubmed/37040227 http://dx.doi.org/10.4103/ijmr.IJMR_759_20 |
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author | Kaur, Tripat Kumar, Parmod Kundra, Tanveer Singh Kaur, Ikjot |
author_facet | Kaur, Tripat Kumar, Parmod Kundra, Tanveer Singh Kaur, Ikjot |
author_sort | Kaur, Tripat |
collection | PubMed |
description | BACKGROUND & OBJECTIVES: Intranasal midazolam-fentanyl is commonly used as pre-medication in paediatric patients, but there is a risk of respiratory depression with this combination. Dexmedetomidine is a drug that preserves respiratory function. The objective of this study was to compare the efficacy of intranasal midazolam-fentanyl and dexmedetomidine-fentanyl in paediatric patients undergoing elective surgeries. METHODS: Hundred children in the age group of 3-8 yr of American Society of Anaesthesiologists physical status grade 1 were randomized into two groups- group A received intranasal midazolam (0.2 mg/kg)-fentanyl (2 µg/kg) and group B received intranasal dexmedetomidine (1 µg/kg)-fentanyl (2 µg/kg) 20 min before induction of general anaesthesia. Heart rate and SpO(2) were monitored. Sedation score, parental separation and response to intravenous cannulation were seen after 20 min. Children were monitored for 2 h for post-operative analgesia by Oucher’s Facial Pain Scale. RESULTS: Sedation scores were satisfactory in both groups, although children in group A were more sedated than in group B. Parental separation and response to intravenous cannulation were comparable in both the groups. The two groups were also haemodynamically comparable intraoperatively. Post-operative heart rate was also comparable at all-time intervals in both the groups except for heart rate at 100 and 120 min which were more in group A. Group A experienced more post-operative pain as assessed by Oucher’s Facial Pain Scale as compared to group B. Children receiving intranasal dexmedetomidine-fentanyl had better post-operative analgesia as compared to those who received intranasal midazolam-fentanyl. INTERPRETATION & CONCLUSIONS: Both intranasal midazolam with fentanyl and intranasal dexmedetomidine with fentanyl provided satisfactory sedation. Both groups were comparable in separation reaction and response to intravenous cannulation with better post-operative analgesia in children receiving intranasal dexmedetomidine-fentanyl. |
format | Online Article Text |
id | pubmed-10284369 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-102843692023-06-22 Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group Kaur, Tripat Kumar, Parmod Kundra, Tanveer Singh Kaur, Ikjot Indian J Med Res Practice: Original Article BACKGROUND & OBJECTIVES: Intranasal midazolam-fentanyl is commonly used as pre-medication in paediatric patients, but there is a risk of respiratory depression with this combination. Dexmedetomidine is a drug that preserves respiratory function. The objective of this study was to compare the efficacy of intranasal midazolam-fentanyl and dexmedetomidine-fentanyl in paediatric patients undergoing elective surgeries. METHODS: Hundred children in the age group of 3-8 yr of American Society of Anaesthesiologists physical status grade 1 were randomized into two groups- group A received intranasal midazolam (0.2 mg/kg)-fentanyl (2 µg/kg) and group B received intranasal dexmedetomidine (1 µg/kg)-fentanyl (2 µg/kg) 20 min before induction of general anaesthesia. Heart rate and SpO(2) were monitored. Sedation score, parental separation and response to intravenous cannulation were seen after 20 min. Children were monitored for 2 h for post-operative analgesia by Oucher’s Facial Pain Scale. RESULTS: Sedation scores were satisfactory in both groups, although children in group A were more sedated than in group B. Parental separation and response to intravenous cannulation were comparable in both the groups. The two groups were also haemodynamically comparable intraoperatively. Post-operative heart rate was also comparable at all-time intervals in both the groups except for heart rate at 100 and 120 min which were more in group A. Group A experienced more post-operative pain as assessed by Oucher’s Facial Pain Scale as compared to group B. Children receiving intranasal dexmedetomidine-fentanyl had better post-operative analgesia as compared to those who received intranasal midazolam-fentanyl. INTERPRETATION & CONCLUSIONS: Both intranasal midazolam with fentanyl and intranasal dexmedetomidine with fentanyl provided satisfactory sedation. Both groups were comparable in separation reaction and response to intravenous cannulation with better post-operative analgesia in children receiving intranasal dexmedetomidine-fentanyl. Wolters Kluwer - Medknow 2023-01 2023-04-04 /pmc/articles/PMC10284369/ /pubmed/37040227 http://dx.doi.org/10.4103/ijmr.IJMR_759_20 Text en Copyright: © 2023 Indian Journal of Medical Research https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Practice: Original Article Kaur, Tripat Kumar, Parmod Kundra, Tanveer Singh Kaur, Ikjot Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group |
title | Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group |
title_full | Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group |
title_fullStr | Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group |
title_full_unstemmed | Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group |
title_short | Comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group |
title_sort | comparison of intranasal midazolam-fentanyl with dexmedetomidine–fentanyl as pre-medication in the paediatric age group |
topic | Practice: Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10284369/ https://www.ncbi.nlm.nih.gov/pubmed/37040227 http://dx.doi.org/10.4103/ijmr.IJMR_759_20 |
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