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Faritus SZ, Khazaee-Koohpar M, Ziyaeifard M, et al. Oral Dexmedetomidine Versus Midazolam as Anesthetic Premedication in Children Undergoing Congenital Heart Surgery. Anesth Pain Med. 2015;5(3):e25032doi: 10.5812/aapm.5(3)2015.25032.
Faritus, S. Z., Khazaee-Koohpar, M., Ziyaeifard, M., & Mehrabanian, M. J. (2015). Oral Dexmedetomidine Versus Midazolam as Anesthetic Premedication in Children Undergoing Congenital Heart Surgery. Anesthesiology and pain medicine, 5(3), e25032. https://doi.org/10.5812/aapm.5(3)2015.25032
Faritus, Seyedeh Zahra, et al. "Oral Dexmedetomidine Versus Midazolam as Anesthetic Premedication in Children Undergoing Congenital Heart Surgery." Anesthesiology and pain medicine vol. 5,3 (2015): e25032. doi: https://doi.org/10.5812/aapm.5(3)2015.25032
Faritus SZ, Khazaee-Koohpar M, Ziyaeifard M, Mehrabanian MJ. Oral Dexmedetomidine Versus Midazolam as Anesthetic Premedication in Children Undergoing Congenital Heart Surgery. Anesth Pain Med. 2015 Jun 22;5(3):e25032. doi: 10.5812/aapm.5(3)2015.25032. eCollection 2015 Jun. PMID: 26161325; PMCID: PMC4493729.
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Anesth Pain Med. 2015 Jun 22;5(3):e25032. doi: 10.5812/aapm.5(3)2015.25032. eCollection 2015 Jun.

Oral Dexmedetomidine Versus Midazolam as Anesthetic Premedication in Children Undergoing Congenital Heart Surgery.

Anesthesiology and pain medicine

Seyedeh Zahra Faritus, Mehrdad Khazaee-Koohpar, Mohsen Ziyaeifard, Mohammad Javad Mehrabanian

Affiliations

  1. Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

PMID: 26161325 PMCID: PMC4493729 DOI: 10.5812/aapm.5(3)2015.25032

Abstract

BACKGROUND: Premedication is required for reducing anxiety and child's struggling against mask acceptance on anesthesia in pediatric surgery for congenital heart disease. Midazolam has been widely used for this purpose, but because of its side effects, finding an effective replacement with less complication is necessary.

OBJECTIVES: In the present study, we compared the efficacy of oral midazolam versus dexmedetomidine in terms of anxiolysis and mask acceptance behavior.

PATIENTS AND METHODS: Sixty children aged between 2 and 12 years, and scheduled for on-pump surgery due to a congenital heart disease were randomly assigned into two groups. Oral midazolam (0.5 mg/kg up to 15 mg per patient) and dexmedetomidine (2 µg/kg) were administered 45 minutes pre-anesthesia. Children's anxiety, mask acceptance behavior, hemodynamic measures, and cardiopulmonary outcomes were recorded and compared.

RESULTS: The mean age of patients was 3.96 ± 2.04 years. Twenty-eight (46.7%) patients were females. Two drugs have similar effects on cardiopulmonary outcomes and hemodynamic measures (P > 0.05). They equally relieved the children's anxiety (mean sedation score 1.93 ± 0.63 and 2.0 ± 0.63 for midazolam and dexmedetomidine groups, respectively; P > 0.05), while dexmedetomidine showed a better effect on improving the mask acceptance behavior (mean mask acceptance score 2.58 ± 0.6 and 1.6 ± 0.67 for midazolam and dexmedetomidine, respectively; P < 0.05).

CONCLUSIONS: It appears reasonable to apply oral premedication with dexmedetomidine 45 minutes before transferring the patient to the operating room when he or she is more prone to resist inhalation anesthesia induction.

Keywords: Analgesics; Anesthesia; Anti-Anxiety Agents; Dexmedetomidine; Inhalation; Midazolam; Premedication

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