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

Faritus SZ, Khazaee-Koohpar M, Ziyaeifard M, Mehrabanian MJ - Anesth Pain Med (2015)

Bottom Line: Children's anxiety, mask acceptance behavior, hemodynamic measures, and cardiopulmonary outcomes were recorded and compared.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).

View Article: PubMed Central - PubMed

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

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.

No MeSH data available.


Related in: MedlinePlus

Anesthesia Score of Two Groups, Midazolam (MIDA) and Dexmedetomidine (DEX) are Compared TogetherP < 0.05 vs. MIDA; ANS1, Calm and cooperating; ANS2, Anxious but without resistance; ANS3, Anxious with slight resistance.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4493729&req=5

fig19153: Anesthesia Score of Two Groups, Midazolam (MIDA) and Dexmedetomidine (DEX) are Compared TogetherP < 0.05 vs. MIDA; ANS1, Calm and cooperating; ANS2, Anxious but without resistance; ANS3, Anxious with slight resistance.

Mentions: Analysis of the mask acceptance behavior at anesthesia induction time revealed that more children receiving dexmedetomidine are calm and cooperate well in terms of mask acceptance while the number of patients with grade 2 of mask acceptance behavior, anxious but without resistance, were higher in midazolam group. These differences were statistically significant (P < 0.05). Also, more patients in the midazolam group were categorized as grade 3 in mask acceptance behavior, and anxious with slight resistance. In sum, dexmedetomidine performed better in 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) (Figure 2).


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

Faritus SZ, Khazaee-Koohpar M, Ziyaeifard M, Mehrabanian MJ - Anesth Pain Med (2015)

Anesthesia Score of Two Groups, Midazolam (MIDA) and Dexmedetomidine (DEX) are Compared TogetherP < 0.05 vs. MIDA; ANS1, Calm and cooperating; ANS2, Anxious but without resistance; ANS3, Anxious with slight resistance.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493729&req=5

fig19153: Anesthesia Score of Two Groups, Midazolam (MIDA) and Dexmedetomidine (DEX) are Compared TogetherP < 0.05 vs. MIDA; ANS1, Calm and cooperating; ANS2, Anxious but without resistance; ANS3, Anxious with slight resistance.
Mentions: Analysis of the mask acceptance behavior at anesthesia induction time revealed that more children receiving dexmedetomidine are calm and cooperate well in terms of mask acceptance while the number of patients with grade 2 of mask acceptance behavior, anxious but without resistance, were higher in midazolam group. These differences were statistically significant (P < 0.05). Also, more patients in the midazolam group were categorized as grade 3 in mask acceptance behavior, and anxious with slight resistance. In sum, dexmedetomidine performed better in 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) (Figure 2).

Bottom Line: Children's anxiety, mask acceptance behavior, hemodynamic measures, and cardiopulmonary outcomes were recorded and compared.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).

View Article: PubMed Central - PubMed

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

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.

No MeSH data available.


Related in: MedlinePlus