<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Introduction</h3><p>Sedative premedication is the mainstay of pharmacological therapy in children undergoing surgeries. This study compares preoperative melatonin, clonidine, and dexmedetomidine on sedation, ease of anesthesia induction, emergence delirium, and analgesia.</p></sec><sec><h3>Materials and Methods</h3><p>One hundred and five children, 3–8 years, either sex, ASA I/II, posted for infraumbilical surgery, randomized to receive clonidine 5 mcg/kg (Group C), dexmedetomidine 3 mcg/kg (Group D), and melatonin 0.2 mg/kg (Group M) 45 minutes before surgery. Preoperative Sedation/Anxiety and Child–Parent Separation Score (CPSS) were assessed. Identical anesthesia technique was utilized. Emergence delirium (Watcha score) and postoperative pain (Objective Pain Scale score) were monitored postoperatively.</p></sec><sec><h3>Results</h3><p>Patients were demographically comparable. Sedation score >Grade 3 was absent. Grades 1/2/3 were present in 10/19/6 (Group C), 2/26/7 (Group D), and 7/26/2 (Group M). Grade 1 CPSS was present in 42.6% (Group C), 37.1% (Group D), and 28.6% (Group M). Pediatric Anesthesia Behavior Score (PABS) was comparable between Groups C and D (p = 0.224; 95% CI −0.090 to 0.604) and Groups C and M (p = 0.144; 95% CI −0.633 to 0.061) while PABS was better in Group D compared to Group M (p = 0.0007; 95% CI −0.890 to −0.195). Watcha scores were 33/2/0/0 (Group C), 34/1/0/0 (Group D), and 32/2/1/0 (Group M) immediately after extubation. Scores were 31/4/0/0 (Group C), 33/2/0/0 (Group D), and 31/4/0/0 (Group M) at 30 minutes and 28/7/0/0 (Group C), 29/6/0/0 (Group D), and 24/11/0/0 (Group M) at 1 hour. The scores were comparable (p > 0.05). Objective Pain Scale scores were comparable between Groups C and D and Groups C and M (p > 0.05). Lower scores were present in Group D compared to M (p = 0.023).</p></sec><sec><h3>Conclusion</h3><p>Melatonin, clonidine, and dexmedetomidine are efficacious for producing preoperative sedation, reducing anxiety, postoperative pain, and emergence delirium.</p></sec></abstract>

IntroductionSedative premedication is the mainstay of pharmacological therapy in children undergoing surgeries. This study compares preoperative melatonin, clonidine, and dexmedetomidine on sedation, ease of anesthesia induction, emergence delirium, and analgesia.Materials and MethodsOne hundred and five children, 3–8 years, either sex, ASA I/II, posted for infraumbilical surgery, randomized to receive clonidine 5 mcg/kg (Group C), dexmedetomidine 3 mcg/kg (Group D), and melatonin 0.2 mg/kg (Group M) 45 minutes before surgery. Preoperative Sedation/Anxiety and Child–Parent Separation Score (CPSS) were assessed. Identical anesthesia technique was utilized. Emergence delirium (Watcha score) and postoperative pain (Objective Pain Scale score) were monitored postoperatively.ResultsPatients were demographically comparable. Sedation score >Grade 3 was absent. Grades 1/2/3 were present in 10/19/6 (Group C), 2/26/7 (Group D), and 7/26/2 (Group M). Grade 1 CPSS was present in 42.6% (Group C), 37.1% (Group D), and 28.6% (Group M). Pediatric Anesthesia Behavior Score (PABS) was comparable between Groups C and D (p = 0.224; 95% CI −0.090 to 0.604) and Groups C and M (p = 0.144; 95% CI −0.633 to 0.061) while PABS was better in Group D compared to Group M (p = 0.0007; 95% CI −0.890 to −0.195). Watcha scores were 33/2/0/0 (Group C), 34/1/0/0 (Group D), and 32/2/1/0 (Group M) immediately after extubation. Scores were 31/4/0/0 (Group C), 33/2/0/0 (Group D), and 31/4/0/0 (Group M) at 30 minutes and 28/7/0/0 (Group C), 29/6/0/0 (Group D), and 24/11/0/0 (Group M) at 1 hour. The scores were comparable (p > 0.05). Objective Pain Scale scores were comparable between Groups C and D and Groups C and M (p > 0.05). Lower scores were present in Group D compared to M (p = 0.023).ConclusionMelatonin, clonidine, and dexmedetomidine are efficacious for producing preoperative sedation, reducing anxiety, postoperative pain, and emergence delirium.

A Comparative Evaluation of Oral Clonidine, Dexmedetomidine, and Melatonin as Premedicants in Pediatric Patients Undergoing Subumbilical Surgeries

Department of Anaesthesiology, Himalayan Institute of Medical Sciences

Department of Surgery, Himalayan Institute of Medical Sciences

Romanian Journal of Anaesthesia and Intensive Care

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

IntroductionSedative premedication is the mainstay of pharmacological therapy in children undergoing surgeries. This study compares preoperative melatonin,...

A Comparative Evaluation of Oral Clonidine, Dexmedetomidine, and Melatonin as Premedicants in Pediatric Patients Undergoing Subumbilical Surgeries

Article Category: Research Article

Published Online: Aug 10, 2020

Page range: 35 - 42

DOI: https://doi.org/10.2478/rjaic-2020-0006

Keywords
Premedication, drugs-melatonin, clonidine, dexmedetomidine

© 2020 Syed T Ali et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

A Comparative Evaluation of Oral Clonidine, Dexmedetomidine, and Melatonin as Premedicants in Pediatric Patients Undergoing Subumbilical Surgeries

Article Category: Research Article

Published Online: Aug 10, 2020

Page range: 35 - 42

DOI: https://doi.org/10.2478/rjaic-2020-0006

KeywordsPremedication, drugs-melatonin, clonidine, dexmedetomidine

© 2020 Syed T Ali et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Premedication, drugs-melatonin, clonidine, dexmedetomidine