Abstract: Background & Objectives: Sedative premedicants may not allow full psychomotor recovery in children leading to risk of injury after discharge. This study aims to compare oral midazolam and nasal dexmedetomidine for their effects on psychomotor recovery in children. Materials & Methods: A randomized double blind study was conducted in 100 ASA I/II children of 2-10y after approval of Institutional Ethics Committee and written informed parental consent. Children with allergy or hypersensitivity reaction to dexmedetomidine or midazolam; organ dysfunction, cardiac arrhythmia or CHD; mental retardation and severe dysfunction of CNS or raised ICP were excluded. Based on block randomization children were allocated to receive oral midazolam 0.5mg/kg and nasal placebo (MDZ) or nasal dexmedetomidine 1µg/kg and oral placebo (DEX) as premedication. Sedation, emotional status and behaviour of the child at separation from parent were evaluated. Anesthesia was induced using O2, N2O (FiO2 0.5) and sevoflurane 8% and LMA introduced. Anaesthesia was maintained with O2, N2O, isoflurane (MAC 1-1.3) and fentanyl (2µg/kg) on controlled ventilation. Post-anesthetic recovery was evaluated using a modified Aldrete score with a score of 9 considered sufficient for discharge. Psychomotor function was assessed using Seguin Form Board Test, Gesell drawing test, Three Hole Form Board Test, Digit Span Test, Mazes and Trail Making Test as per children’s age performed on the morning of surgery, prior to premedication (T0), postoperatively when Aldrete score of 9 was achieved (T1). The results were analyzed using chi square test and t test as applicable. Kaplan Meier survival analysis was done for time taken to reach Aldrete score of 9. Results: Emotional status after 30 minutes of premedication showed favourable scores in group MDZ compared to patients in group DEX (p=0.007). The parental separation score was comparable in the 2 groups. Mean time to reach Aldrete score of 9 was 39 min [95% CI (35-42.5 min)] in group MDZ and 30 min [95% C.I (26.8-33.2min)] in group DEX (p=0.001).Conclusion: Both midazolam and dexmedetomidine produced similar parental separation, sedation and emotional scores. Lesser number of children receiving midazolam were anxious. The psychomotor recovery profile favoured demedetomidine. References: 1. Jatti K, Batra YK, Bhardwaj N et al. Int J Clin Pharmacol Ther 1998; 36: 336-39. Disclosure of Interest: None declared
Publication Year: 2016
Publication Date: 2016-08-25
Language: en
Type: article
Indexed In: ['crossref']
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot