Comparative Trial of Intravenous Dexmedetomidine versus Midazolam Premedication on Quality of Sedation in Upper Gastrointestinal Endoscopy in Children

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Upper gastrointestinal endoscopy is one of the most common outpatient diagnostic and therapeutic interventions in children. Present study aimed to compare the sedative effect of intravenous dexmedetomidine premedication versus midazolam in children undergoing upper gastrointestinal endoscopy.Methods: This was a double-blind randomized trial in which 72 patients were allocated in two groups of 36 undergoing premedication with intravenous (IV) midazolam and dexmedetomidine, respectively. Sedation scale, mean arterial pressure, heart rate, recovery time, and respiratory complications were recorded and compared.Findings: Sedation score was significantly higher with midazolam at 15 minutes following injection (P = 0.005), on admission to recovery (P < 0.001), and 30 minutes after admission to recovery (P = 0.001). Recovery time was significantly longer in midazolam premedication (P < 0.001). Respiratory complications were significantly more frequent with midazolam (P = 0.030).Conclusion: Although dexmedetomidine premedication was associated with lower mean arterial pressure and heart rate, intra-operative and recovery sedation scores were significantly higher with midazolam premedication.

Keywords

References

  1. Rahman I, Patel P, Boger P, Rasheed S, Thomson M, Afzal NA. Therapeutic upper gastrointestinal tract endoscopy in paediatric gastroenterology. World J Gastrointest Endosc 2015; 7(3): 169-82.
  2. Faritus SZ, Khazaee-Koohpar M, Ziyaeifard M, Mehrabanian MJ. Oral dexmedetomidine versus midazolam as anesthetic premedication in children undergoing congenital heart surgery. Anesth Pain Med 2015; 5(3): e25032.
  3. Eskandarian T, Arabzade MS, Reza GS, Bayani M. The effect of nasal midazolam premedication on parents-child separation and recovery time in dental procedures under general anaesthesia. Eur J Paediatr Dent 2015; 16(2): 135-8.
  4. Peng K, Wu SR, Ji FH, Li J. Premedication with dexmedetomidine in pediatric patients: A systematic review and meta-analysis. Clinics (Sao Paulo) 2014; 69(11): 777-86.
  5. Akin A, Bayram A, Esmaoglu A, Tosun Z, Aksu R, Altuntas R, et al. Dexmedetomidine vs midazolam for premedication of pediatric patients undergoing anesthesia. Paediatr Anaesth 2012; 22(9): 871-6.
  6. Nishizawa T, Suzuki H, Sagara S, Kanai T, Yahagi N. Dexmedetomidine versus midazolam for gastrointestinal endoscopy: A meta-analysis. Dig Endosc 2015; 27(1): 8-15.
  7. Wu W, Chen Q, Zhang LC, Chen WH. Dexmedetomidine versus midazolam for sedation in upper gastrointestinal endoscopy. J Int Med Res 2014; 42(2): 516-22.
  8. Vazquez-Reta JA, Jimenez Ferrer MC, Colunga-Sanchez A, Pizarro-Chavez S, Vazquez-Guerrero AL, Vazquez-Guerrero AR. Midazolam versus dexmedetomidine for sedation for upper gastrointestinal endoscopy. Rev Gastroenterol Mex 2011; 76(1): 13-8. [In Spanish].
  9. Kuyrukluyildiz U, Binici O, Onk D, Ayhan CS, Torun MT, Unver E, et al. Comparison of dexmedetomidine and propofol used for drug-induced sleep endoscopy in patients with obstructive sleep apnea syndrome. Int J Clin Exp Med 2015; 8(4): 5691-8.
  10. Zhang F, Sun HR, Zheng ZB, Liao R, Liu J. Dexmedetomidine versus midazolam for sedation during endoscopy: A meta-analysis. Exp Ther Med 2016; 11(6): 2519-24.
  11. Rahimi-Varposhti M, Moradi-Farsani D, Salehnia A, Montazeri K, Shafa A. Effects of magnesium sulfate on pain, nausea/vomiting, and anesthetic consumption after corneal transplantation and vitrectomy. J Isfahan Med Sch 2017; 35(423): 278-84. [In Persian].
  12. Moradi Farsani D, Naghibi K, Alikiaei B, Mashayekhi Z. Comparison of the effects of intravenous phenylephrine and ephedrine in treatment of hypotension after spinal anesthesia in orthopedic surgery. J Babol Univ Med Sci 2016; 18(6): 21-7. [In Persian].
  13. Moradi-Farsani D, Naghibi K, Taheri S, Ali-Kiaii B, Rahimi-Varposhti M. Effects of age and gender on acute postoperative pain after cataract surgery under topical anesthesia and sedation. J Isfahan Med Sch 2017; 34(414): 1627-33. [In Persian].
  14. Moradi-Farsani D, Akrami F, Naghibi K, Alikiaii B, Nazemorroaya B. The effect of age and sex on postoperative pain after deep vitrectomy. J Isfahan Med Sch 2017; 34(415): 1660-5. [In Persian].
Journal of Isfahan Medical School
Volume 35, Issue 451 - Serial Number 451
September and October 2017
Pages 1418-1423

Files

History

  • Receive Date: 04 August 2017
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics