Oral Midazolam as Pre-Medication for Children Undergoing Elective Surgical Procedures

What is it about?

Oral Midazolam as Pre-Medication for Children Undergoing Elective Surgical Procedures

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Why is it important?

Pre-medications are frequently administered in children to alleviate the stress and fear of treatment as well as to ease child-parent separation and promote a smooth induction of anesthesia. Various drugs have been tried ranging from midazolam, ketamine, fentanyl, promethazine, and triclorfos. Of late alpha-2 agonists like Dexmedetomidine are being used, it has both sedative and analgesic properties and is devoid of respiratory depressant effect. These properties render it potentially useful for anesthesia pre-medication. Aim is to compare the effects of midazolam and dexmedetomidine when administered orally as pre-anesthetic medication for children. Materials and Methods: Children are randomised into Group M receiving midazolam 0.5 mg/kg and Group D receiving dexmedetomidine 2 mcg/kg orally. Results: Demographic and hemodynamic parameters are comparable between two drugs. Child separation Score 1 in Group D is 29 out of 35 (83%) and in Group M is 16 out of 35 (45.7%) with p value of < 0.05. Mask acceptance Score 1 and 2 in Group D is 34 out of 35 (97.2%) where as in Group M is 22 out of 35 (62.8%) with p-value of < 0.05. Sedation score of 2 and 3 in Group D is 29 out of 35 (82.9%) and Group M is 32 out of 35 (91%) with p value of > 0.05. Dexmedetomidine is a better drug in terms of child parent separation and mask acceptance score than midazolam. However, sedation scores were comparable. To conclude Dexmedetomidine is a superior pre-medication compared to Midazolam when given by oral route. Dexmedetomidine may find a regular place for pre-medication in children pre-operatively.

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