Dexmedetomidine versus Midazolam as Premedication in Anesthesia: A Meta-Analysis from Randomized Controlled Clinical Trials

Abstract

Dexmedetomidine [Dex] is an α2-adrenoceptor agonist which provides sedation, analgesia and anxiolytic effects, thus making it a potentially useful anesthetic premedication. A number of clinical trials have been conducted to compare the sedative effect of Dex versus midazolam [Mdz], a conventional sedative agent in anesthesia. Nevertheless, consensus has not been achieved on which agent is superior to the other in terms of the overall benefit to patients. In this study, we have isolated four independent studies containing randomized, controlled, clinical trials on patients and compare the efficacy and safety of these two agents as a premedication in anesthesia. In the studies of the catheter ablation of atrial fibrillation and surgical correction of scoliosis deformities, Dex treatment resulted in a better sedative and analgesic effects, reflected by a reduced pain, a lower dose of analgesic agents required, and greater sedation scores than Mdz treatment. Similarly, intranasal Dex premedication in the children's dental rehabilitation and adenotonsillectomy, Dex also yielded a better efficacy. Taken together, Dex provides an improved premedication for sedation and analgesia, as well as the protective effects on the end organs. This study has provided evidence for optimized sedation protocol in anesthesia. J o u rn al of A n e s th es ia & C li n ic a l Resea rc h

Intramuscular Dexmedetomidine Versus Midazolam as a Premedication Before Surgery

“…Unclearly great quanti iably, non proportionateanxiolysis was found in this appraisal which could be an eventual outcome of fentanyl improvement to midazolam. (Zhou and Zhao, 2014) isolated dexmedetomidine and midazolam as a premedication in their meta-appraisal, their results thought about that dexmedetomidine premedication achieved an otherworldly facilitating and anxiolytic effect during watchman division. (Mahfouz et al, 2011) guided an evaluation to explore intranasal dexmedetomidine versus oral midazolam for premedication of young people.…”

Randomized Double Blind Clinical Trial of Intramuscular Dexmedetomidine v/S Midazolam as Premedication in Paediatric Surgical Patients

“…C Zhou. 20 Ke Peng. 21 and Pasin L. compared dexmedetomidine with midazolam as a premedication in their meta-analysis; their results concluded that dexmedetomidine premedication resulted in a better sedative and anxiolytic effect during parent separation.…”

Effect of oral clonidine premedication on PR interval in patients undergoing rhinoplasty and functional endoscopic sinus surgery (FESS)

“…3 Acting selectively on α2-receptors with 200 times greater affinity than α-receptors, clonidine primarily functions as an antihypertensive agent, inhibiting norepinephrine release and consequently curbing sympathetic activity and peripheral vasodilatation. [5][6][7] Apart from its hemodynamic effects, clonidine induces negative chronotropy, hypotension, 5,[8][9][10][11][12] and exhibits sedative properties through stimulation of α2-receptors in the central nervous system. [13][14] Administered orally, clonidine boasts rapid and nearly complete absorption from the gastrointestinal tract, exhibiting 100% bioavailability.…”