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Intranasal Clonidine vs. Midazolam as Premedication in Children: A Randomized Controlled Trial

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Abstract

Objectives

To compare anxiolysis produced by intranasal clonidine with intranasal midazolam as premedication in children undergoing surgery.

Design

Double-blind randomized controlled study.

Setting

Tertiary-care hospital, July 2009 to June 2010.

Patients

60 American Society of Anesthesiologists physical status I–II surgical patients aged 1–10 yr.

Intervention

Participants randomly allocated to receive either intranasal clonidine 4 mcg/kg (Group I) with atropine or intranasal midazolam 0.3 mg/kg (Group II).

Outcome Measures

Primary: satisfactory anxiolysis at 30 min after drug administration. Secondary: satisfactory mask acceptance, times of onset of sedation and anxiolysis, drug acceptance, level of sedation, wake-up score and side effects.

Results

All children achieved satisfactory anxiolysis at 30 min. Group I fared significantly better than Group-II on mask acceptance (100% in Group I vs. 80% in Group II; P=0.024), drug acceptance (93% vs. 13%; P<0.001) and proportion of patients with satisfactory wake-up scores (100% vs. 53%; P<0.001). Group II patients had significantly faster onset of sedation (median 10 min vs. 15 min; P<0.05) but not that of anxiolysis compared to Group-I (median 10 min for both groups; P>0.05). Side effects were significantly more frequent in Group II.

Conclusions

Though intranasal midazolam produced faster sedation, both the drugs produced satisfactory anxiolysis at 30 min.

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Authors and Affiliations

  1. Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India

    Sukanya Mitra, Sunita Kazal & Lakesh K. Anand

  2. 203-B, New Type-V Flats, Sector 24-A, Chandigarh, 160023, India

    Sukanya Mitra

Authors
  1. Sukanya Mitra
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  2. Sunita Kazal
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  3. Lakesh K. Anand
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Correspondence to Sukanya Mitra.

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Mitra, S., Kazal, S. & Anand, L.K. Intranasal Clonidine vs. Midazolam as Premedication in Children: A Randomized Controlled Trial . Indian Pediatr 51, 113–118 (2014). https://doi.org/10.1007/s13312-014-0352-9

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  • DOI: https://doi.org/10.1007/s13312-014-0352-9

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