Comparison between dexmedetomidine and midazolam premedication in pediatric patients undergoing ophthalmic day-care surgeries

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 a2 agonist, has been suggested as an alternative. Dexmedetomidine is a more a2 selective drug with more favorable pharmacokinetic properties than clonidine. AIMS: To compare i.v. Dexmedetomidine and Midazolam as premedication in pediatric patients. SETTINGS AND DESIGN: Open label single blind study. MATERIAL AND METHODS: 60 patients were randomly allocated to group D(n=30) and group M(n=30) and given Inj Dexmedetomidine 0.4 μg/kg diluted in 10 ml slowly i.v. and Inj Midazolam 0.05mg/kg i.v. accordingly. Level of sedation, parent separation, response to induction, blood pressure, pulse, oxygen saturation, post operative agitation and shivering was noted. STATISTICAL ANALYSIS USED: Unpaired student's t-test and chi square test used in this study. P value <0.05 was considered significant. RESULTS: There were significant differences in parental separation acceptance,Response to induction and wake-up behavior score. When compared with group M, patients in groupD were significantly more sedated % minutes after premedication (P<0.001). Post operative agitation and shivering was low in group D in comparision with group M. Though blood pressure and pulse were on lower side in group D than in group M, oxyden saturation remained same in both the groups having no statistical significance. CONCLUSIONS: Dexmedetomidine is superior than Midazolam as premedication in pediatric patients with more intense sedation, excellent parent separation, favourable induction conditions, lower incidence of postoperative agitation and shivering along with hemodynamic stability and no respiratory depression.