الفهرس 
SEDATION FOR PEDIATRIC ENDOSCOPYOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Upper GI endoscopy is one of the most common surgical procedures performed in pediatric patients. Relieving pre- and post- operative anxiety is an important concern for the pediatric anesthesiologist. Anxiety can produce aggressive reactions, increase distress, and may make the control of postoperative pain difficult. Pre-anesthetic medication in children should aim at relieving this anxiety and psychological trauma and also to facilitate the induction of anesthesia without prolonging the recovery.
Aim of the Work: The aim of this work is to compare the effectiveness of intranasal dexmedetomidine and midazolam as a premedication in sedation of preschool children in GI endoscopy.
Patients and Methods: A prospective, randomized and double blind clinical trial was done after approval of institutional ethics committee in Ain Shams University Hospitals for 6 months and obtaining an informed written consent from parents. It was designed to include 70 pediatric patients, aged 2 to 6 years old of both genders, with physical status ASA I – II.
Results: In the present study, the children were satisfactorily separated from parents in dexmedetomidine group when compared to the midazolam group; p value <0.001 as also documented by Ayushi that Parental separation was successful in 73.3% of patients in group SD compared with 46.7% of patients in group SM (P = 0.035). Furthermore, children in dexmedetomidine group achieved significant lower agitation and delirium postoperative after drug in comparison to midazolam group; regarding delirium: p value <0.001, and regarding agitation: p value <0.001.
Conclusion: Premedication with intranasal dexmedetomidine 1 μg/kg attained significant and satisfactory sedation with better parent separation and lower agitation and delirium in the postoperative period as compared to intranasal midazolam 0.2 mg/kg in children undergoing upper GI endoscopy although dexmedetomidine had a delayed onset of action when compared to that of midazolam.