Midazolam-Dexmedetomidine Combination versus Midazolam Alone for Premedication in Children Undergoing Pediatric Cataract Surgeries: a Double?Blinded Randomized Controlled Trial

Background: Dexmedetomidine, a selective ?2 agonist has shown promising results when used as premedicant. This prospective randomized study evaluated the efficacy of two different premedication regimens in achieving smooth conduct anesthesia and optimum pain relief pediatric cataract surgeries. Methods: 90 ASA I or II children, aged 1-6 years, scheduled for elective surgeries were to receive either 0.25 mg kg-1oral midazolam 1?g kg-1 intranasal dexmedetomidine (Group MD; n=45) 0.5mg/kg oral followed by 0.02ml saline drops MS; 45 min prior surgery. Drug acceptance, anxiety at parental separation quality mask induction was evaluated. Subtenon block given all children. Intraoperative use narcotics avoided only rescue drug. Primary outcome number patients requiring analgesia over 24-hour period. The secondary outcomes time first analgesia, frequency incidence OCR PONV. Results: 90% children Group MD achieved MOAA/S ? 4 30 minutes versus 95% MS. acceptability, acceptance similar both groups. Incidence PONV who required less group compared with MS group. There no event Conclusion: Premedication combined IND low dose is superior decreasing postoperative analgesic requirements routine alone under general anesthesia.