Comparison between oral dexmedetomidine and oral midazolam as premedicant in children undergoing herniotomy

Background and Aims: Midazolam has been the most popular premedicant in children despite its side effects. Dexmedetomidine with its favourable clinical profile is a suitable alternative, but with limited research. The aim of this study was to compare the effectiveness of dexmedetomidine and midazolam as oral premedicants in children

Materials and methods: 80 children of ASA PS I scheduled for elective herniotomy were included in this prospective randomized observational study. Patients were randomly assigned to receive either dexmedetomidine 4microgram/ kg or midazolam 0.5mg/kg orally 40min prior to induction. Preoperative sedation, response to parental separation and venepuncture, emergence agitation, recovery nurse satisfaction and side effects were compared between the two groups. quantitative data were compared using the unpaired Student"s t- test and categorical variables with Chi-square test

Results: Pre-operative sedation, response to parental separation and venepuncture were similar among the two groups. The dexmedetomidine grouo had a significantly lower incidence and severity of emergence agitation. Recovery nurse satisfaction was also higher in the dexmedetomidine group. However, incidence of bradycardia and hypotension was more.

Conclusion: Premedication with oral dexmedetomidine is as effective as oral midazolam and produces lesser emergence agitation, though side effects like hypotension and bradycardia may occur