Comparison of Sublingual Midazolam and Dexmedetomidine for Premedication in Children.

N/A

One of the challenges in paediatric anaesthesia is to minimize distress for children in the operating room environment and to facilitate a smooth induction of anaesthesia. Pre-anaesthetic medication reduces the risk of adverse psychological and physiological sequelae of anaesthesia induction in a distressed child. Midazolam is the most commonly used drug for this purpose. Undesirable effects of midazolam such as restlessness, paradoxical reaction and negative postoperative behavioural changes have made it less than an ideal premedication. Dexmedetomidine is a potent, specific and selective ß2-adrenoceptor agonist. It not only produces sedation but also produces anxiolysis, analgesia and decreased activity of sympathetic nervous system. It does not depress respiratory drive. Pharmacological sedation produced by dexmedetomidine mimics natural sleep, making it a promising agent for paediatric sedation.
Because of the unique pharmacological properties of dexmedetomidine we hypothesize that dexmedotomidine may prove to be a better drug for premedication in children as compared to midazolam.

Time at which the child enters the preoperative suite to the time at which the child is discharged from the post-anaesthesia care unit (also include the duration of anaesthesia).

Children will be randomly allocated into two groups:

1. Group I - 0.25 mg/kg midazolam will be given sublingually (drug to be retained in the mouth without spitting or swallowing) by asking the child to place the tip of the tongue to the back of upper teeth. The medication will be given atleast 20 minutes before induction of anaesthesia;

2. Group II- 1.5 µg/kg dexmedetomidine will be given sublingually (drug to be retained in the mouth without spitting or swallowing) by asking the child to place the tip of the tongue to the back of upper teeth. The medication will be given approximately 45 minutes before induction of anaesthesia.