Intranasal Dexmedetomidine Vs Intranasal Midazolam as Premedication in Children Undergoing Tonsillectomy

Abstract

Background: The pre-operative period is a very stressful event for most of the individuals undergoing surgery especially the pediatric patients. So, relieving their pre-operative anxiety becomes an important concern for an anesthesiologist. Many anesthetic pre-medications are used to relieve this stress response. Of these pre-medications, midazolam and dexmedetomidine are effectively used as sedatives. The present study was planned to compare intranasal dexmedetomidine with intranasal midazolam as a pre-anesthetic medication in children. A total of 100 children aged 6–12 years, of either sex, weighing 18–32 kg, with American Society of Anesthesiologists (ASA) physical status 1 and undergoing elective adenotonsillectomy surgery were enrolled in this comparative prospective, double blinded, randomized clinical study. The children were divided into 2 groups: group D and group M, of 24 each. Sixty minutes before induction of anesthesia, group D (n = 50) received intranasal dexmedetomidine at a dose of 1 μg/kg and group M (n = 50) received intranasal midazolam of 0.2 mg/kg. Results: Children who were pre-medicated with dexmedetomidine had lower sedation scores, lower anxiety levels, easier child-parent separation, better mask acceptance than those who received midazolam. The incidence of emergence agitation was decreased in both groups with no significant difference. Conclusion: Intranasal dexmedetomidine seems to have more advantages compared with midazolam. Thus, it can be used safely as a pre-anesthetic medication in children undergoing any surgical procedures under general anesthesia.