Anamika Mishra, Yatendra Gupta, Rajeev Puri, Shailendra Chak, Trilok Chand


The  aim  of  this  prospective  study  was  to  compare intranasal dexmedetomidine, oral clonidine & oral midazolam as premedicating agent on children undergoing surgeries under general anaesthesia. This study was conducted on 96 patients of ASA grade 1 & 2 of either sex between 2-12 years age undergoing routine surgeries. Patients are randomly allocated in 3 groups-M,C and D on basis of premedication given and were assessed on the basis of Preoperative degree of sedation and change in behavior, separation anxiety, effect of emergence agitation after surgery & adverse effects.

Sedation status at parental separation of children from group D were significantly different from group C & M. Emergence agitation scores of children from group C & D were significantly different from group M. Children between 2-5yr age showed statistically significant reduction in emergence agitation in group D. No statistically significant difference groupwise regarding  ease in separation of child from parents & post operative nausea vomiting (PONV) among 3 groups. So to conclude sedation and attenuation in emergence agitation was best with dexmedetomidine followed by clonidine and least with midazolam.


Dexmedetomidine, Clonidine, Midazolam, Sedation, Parental Separation.

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White PF: Pharmacologic and clinical aspects of preoperative medication. Anesth analg. 1986;65:963

Kain ZN, Mayes LC, O’connor TZ, Cichetti DV: preoperative anxiety in children: Predictors and outcomes. Arch Pediatr Adolesc Med 1996;150:1238-45

Mccann ME, Kain ZN: The management of preoperative anxiety in children: An update. Anesth analg.2001;93:98-105

Schmidt AP, Valineti EA, Banderia D, Bertacchi MF, Simoes CM, Auler JO: effects of preanesthetic administration of midazolam, clonidine or dexmedetomidine on postoperative pain and anxiety in children. Paediatr Anaesth.2007;17:667-74

Almenrader N, Passariello M, Coccetti B, Haiberger R, Pietropaoli P: Steal-induction after clonidine premedication: Paediatr Anaesth 2007;17:230-4.

Marshall J, Rodarte A, Blumer J, Khook C, Akbari B, Kearns G: Paediatric pharmacodynamics of midazolam oral syrup, paediatric research unit network. J.clin pharmacology 2000;40:578-89.

Cox RG, Nemish U, Ewen A, Crowe M-J: Evidence basd cinical update: does premedication with oral midazolam lead to improved behavioural outcome in children? Can J Anaesthesiol. 2006;53:1213-19.

Karim kamal, Dina soliman, Dina zakaria: Oral dexemedetomidine versus oral midazolam as premedication in children. Ain shams journal of anaesthesiology. 2008 volume1.

Mizrak A, Koruk,Ganidagli S, Bulut M, Oner U: Premedication with dexmedetomidine and midazolam attenuates agitation after electroconvulsive therapy. J Anesth. 2009;23(1):6-10.

Su F, Hammer GB: Dexmedetomidine:paediatric pharmacology, clinical uses and safety, expert opin drug saf. 2011;10:55-66.

Edno magahaes, TSA, Catia souse Goviea et al: Relationship between dexmedetomidine continuous infusion and end tidal sevoflurane concentration monitored by bispectral analysis. Rev. Bras. Anaesthesiology;54-3.

Kaya C, Kelsaka E et al: Does dexmedetomidine premedication have an effect on stress response? European Journal of anaesthesiology. 2006;23:156-7.

Esra sagiroglu, Melek celik et al: Different doses of dexmedetomidine on controlling hemodynamic responses to tracheal intubation. The international journal of anaesthesiology, 2010. Volume 27 number 2, DOI:10.5580/1c 81.

Kain ZN, Caldwell-Andrews AA, et al: Trends in the practice of parental presence during induction of anaesthesia and the use of preoperative sedative premedication in United states,1995-2002: rsults of a follow up national survey. Anesth analog 2004;98:1252-9.


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