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Is midazolam superior to triclofos and hydroxyzine as premedicant in children?

Chaudhary S, Jindal R, Girotra G, Salhotra R, Rautela RS, Sethi AK - J Anaesthesiol Clin Pharmacol (2014)

Bottom Line: Hydroxyzine was found to have lesser sedative effect as compared to both midazolam and triclofos.No major adverse effects were observed.Midazolam was found to be a better premedicant in terms of sedation, anxiolysis and safety.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India.

ABSTRACT

Background: Search for an ideal premedicant drug for children is still on. A prospective, randomized trial was conducted to compare the efficacy of midazolam, triclofos and hydroxyzine as premedication in children undergoing lower abdominal surgeries.

Materials and methods: Sixty American Society of Anesthesiologists I or II patients 2-8 years of age, scheduled for elective lower abdominal surgery were included. The patients were randomly divided into three groups M, T and H of 20 children each who received midazolam 0.5 mg/kg, triclofos 75 mg/kg and hydroxyzine 0.5 mg/kg respectively, orally 60 min before surgery. The acceptability of drugs, level of sedation, anxiety during separation and on mask application was assessed.

Results: The acceptability of midazolam and hydroxyzine was better than triclofos. Hydroxyzine was found to have lesser sedative effect as compared to both midazolam and triclofos. No major adverse effects were observed.

Conclusion: Midazolam was found to be a better premedicant in terms of sedation, anxiolysis and safety.

No MeSH data available.


Related in: MedlinePlus

Sedation score (assessed at 30 and 60 min after premedication) (Excellent = Child awake and oriented (1)/Drowsy (2), Adequate = Eyes closed, but rousable to command (3)/Eyes closed but rousable to mild physical stimulation (4), Inadequate = Eyes closed but unarousable to mild physical stimulation (5))
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Figure 2: Sedation score (assessed at 30 and 60 min after premedication) (Excellent = Child awake and oriented (1)/Drowsy (2), Adequate = Eyes closed, but rousable to command (3)/Eyes closed but rousable to mild physical stimulation (4), Inadequate = Eyes closed but unarousable to mild physical stimulation (5))

Mentions: Maximum percentage of patients achieving excellent sedation scores at 60 min were seen in the midazolam group (Group M). In triclofos group (Group T), 30% children achieved excellent level of sedation by 30 min, which increased to 50% at 60 min whereas only 5% children attained excellent score at 60 min in hydroxyzine group (Group H). Hydroxyzine was found to have mild sedative effect as compared to both midazolam and triclofos [Figure 2]. This difference was found to be statistically highly significant (P = 0.001). Most of the children, in midazolam and triclofos group (95% each) remained calm and sleepy whereas there were lesser number of children in hydroxyzine group who were calm (65%) and 5% children in this group were crying at the time of separation [Figure 3].


Is midazolam superior to triclofos and hydroxyzine as premedicant in children?

Chaudhary S, Jindal R, Girotra G, Salhotra R, Rautela RS, Sethi AK - J Anaesthesiol Clin Pharmacol (2014)

Sedation score (assessed at 30 and 60 min after premedication) (Excellent = Child awake and oriented (1)/Drowsy (2), Adequate = Eyes closed, but rousable to command (3)/Eyes closed but rousable to mild physical stimulation (4), Inadequate = Eyes closed but unarousable to mild physical stimulation (5))
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927293&req=5

Figure 2: Sedation score (assessed at 30 and 60 min after premedication) (Excellent = Child awake and oriented (1)/Drowsy (2), Adequate = Eyes closed, but rousable to command (3)/Eyes closed but rousable to mild physical stimulation (4), Inadequate = Eyes closed but unarousable to mild physical stimulation (5))
Mentions: Maximum percentage of patients achieving excellent sedation scores at 60 min were seen in the midazolam group (Group M). In triclofos group (Group T), 30% children achieved excellent level of sedation by 30 min, which increased to 50% at 60 min whereas only 5% children attained excellent score at 60 min in hydroxyzine group (Group H). Hydroxyzine was found to have mild sedative effect as compared to both midazolam and triclofos [Figure 2]. This difference was found to be statistically highly significant (P = 0.001). Most of the children, in midazolam and triclofos group (95% each) remained calm and sleepy whereas there were lesser number of children in hydroxyzine group who were calm (65%) and 5% children in this group were crying at the time of separation [Figure 3].

Bottom Line: Hydroxyzine was found to have lesser sedative effect as compared to both midazolam and triclofos.No major adverse effects were observed.Midazolam was found to be a better premedicant in terms of sedation, anxiolysis and safety.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India.

ABSTRACT

Background: Search for an ideal premedicant drug for children is still on. A prospective, randomized trial was conducted to compare the efficacy of midazolam, triclofos and hydroxyzine as premedication in children undergoing lower abdominal surgeries.

Materials and methods: Sixty American Society of Anesthesiologists I or II patients 2-8 years of age, scheduled for elective lower abdominal surgery were included. The patients were randomly divided into three groups M, T and H of 20 children each who received midazolam 0.5 mg/kg, triclofos 75 mg/kg and hydroxyzine 0.5 mg/kg respectively, orally 60 min before surgery. The acceptability of drugs, level of sedation, anxiety during separation and on mask application was assessed.

Results: The acceptability of midazolam and hydroxyzine was better than triclofos. Hydroxyzine was found to have lesser sedative effect as compared to both midazolam and triclofos. No major adverse effects were observed.

Conclusion: Midazolam was found to be a better premedicant in terms of sedation, anxiolysis and safety.

No MeSH data available.


Related in: MedlinePlus