Comparative study between nebulized dexmedetomidine and nebulized midazolam in reducing preoperative anxiety and emergence delirium in children undergoing lower abdominal surgeries

Document Type : Original Article

Authors

Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University

10.21608/asja.2024.291426.1112

Abstract

Background and Aims: An ideal premedication drug should result in a sedated child to allow easy separation of a child from the parents, facilitating smooth induction of anesthesia and a pleasant perioperative experience for both children and parents the present study evaluated the safety and efficacy of nebulized dexmedetomidine in a dose of 3 µg/kg and nebulized midazolam in a dose of 0.3mg/kg in reducing preoperative anxiety and emergence delirium in children undergoing lower abdominal surgeries.
Methods: A prospective, randomized, double-blind study was done involving 60 children of age 3–8years, randomly allocated into two equal groups and pre-medicated with either nebulized dexmedetomidine 3 μg/kg (Group D),or midazolam 0.3 mg/kg (Group M). The scores of sedation scale, parental separation anxiety scale, mask acceptance scale and emergence agitation scale were compared along with hemodynamic parameters, total narcotics consumption, recovery time and postoperative nausea and vomiting.
Results: Dexmedetomidine provided statistically significant Parental Separation and emergence delirium than midazolam with P value 0.003 and 0.001 respectively. Moreover both provide satisfactory mask acceptance with no statistically significant difference regarding adverse effects as hypotension, bradycardia and postoperative nausea and vomiting.
Conclusion: Children premedicated with nebulized demedetomidine in the dose of 3μg/kg experienced more satisfactory peroperative sedation and emergence delirium, better mask acceptance, shorter recovery time and lower perioperative narcotics use than children premedicated with nebulized midazolam with no significant increase in the incidence of bradycardia or hypotension.

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