Anxiety/distress during induction of anaesthesia in children premedicated with clonidine versus midazolam

• Background: Children get sedative premedication in order to avoid preoperative anxiety/distress and to get a smooth induction of anaesthesia. Midazolam has been the standard premedication since many years. Recent studies with clonidine has shown good results. We hypothesized that clonidine would be as good as midazolam at getting a calm child and a less distressful induction.Material and methods: A prospective, randomised, blinded study including 116 children 2 - <8 years of age, ASA I-II who underwent ear-nose-throat outpatient surgery in Skellefteå Hospital. EudraCT Number: 2012-005215-42. The children were randomised to premedication with either oral clonidine 4 µg/kg body weight or oral midazolam 0.5 mg/kg body weight. The children were observed preoperatively, from entering the operating room and during the induction of anaesthesia and evaluated using the modified observational instrument Yale Preoperative Anxiety Scale (m-YPAS). The values in the two groups were statistically compared with chi-square test.Results: There was a significant difference between the two groups in favour of midazolam. The children in the clonidine group had higher  m-YPAS score  showing more anxiety/distress during induction. With prospective subgroup analysis for age groups, there was a much more pronounced difference between groups for the younger children aged 2 up to 5 years of age.Conclusion: Premedication with midazolam, compared to clonidine, appears to lead to less anxiety/distress during induction of anaesthesia in younger children from 2 up to 5, though with less pronounced effect for children 5 up to  8 years of age. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

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