Comparison of Oral Clonidine and Midazolam as Premedications in Children
Dr. Rubina Khullar Mahajan
100-Dayanand Nagar, Lawrence Road, Amritsar, India.
Phone No. 09585887884
Background: Oral premedication is widely being used in paediatric anaesthesia to reduce the pre-operative anxiety and to ensure a smooth induction. Midazolam is currently the most commonly used premedicant in children. Clonidine, an alpha-2 agonist due to its sedative properties, is also being used.
Aim: The aim of the present study was to compare the clinical effects of oral midazolam and oral clonidine.
Settings and Design: This study was conducted as a single blind trial on 60 children who were in the age group of 2-8 years.
Methods and Material: The children were randomly divided into two groups and they were given either clonidine 4 mcg/kg (Group I, n=30) or midazolam 0.5 mg/kg (Group II, n=30) orally, which were dissolved in honey and water solution, 60 minutes prior to the mask induction. The drug acceptance, pre-operative sedation and anxiolysis, parental separation, quality of induction and mask acceptance, the effect on the haemodynamics and the adverse effects were evaluated.
Statistical Analysis Used: All the values were reported as range and meanÂ±SD. The data analysis for the numerical data was performed by the unpaired Studentâ€™s t-test and for the categorical data, the analysis was performed by the Fisherâ€™s exact test or the Chi-Square test. Other data were reported as mean Â± SD or frequency (%). A p value of≤ 0.05 was considered as statistically significant.
Results and Conclusions: Oral clonidine tasted significantly better than oral midazolam. The onset of the sedation was significantly faster after the premedication with midazolam (30.5 Â± 10.8 minutes) than with clonidine (38.5 Â± 12.26 minutes). A satisfactory sedation could be achieved with both the drugs, but the quality of the sedation was significantly better after the premedication with clonidine. The difference in the onset of the anxiolysis was found to be statistically insignificant. A satisfactory anxiolysis was achieved with both, but the quality of the anxiolysis was better with clonidine. The quality of the mask induction was equally satisfactory in both the groups. A steal-induction was performed on 56.7% of the patients of the clonidine group, but on none in the midazolam group. No adverse effects like bradycardia, hypotension, hypoxaemia or apnoea were observed during the peri-operative period in both the clonidine and the midazolam groups. We concluded that oral clonidine is a good alternative to oral midazolam as a premedication in children.