title: Comparative evaluation of midazolam and clonidine as pediatric oral premedication.
abstract: BACKGROUND
  Clonidine provides many desirable effects like sedation, analgesia, anxiolysis, and hemodynamic stability and these properties make it a potentially useful anesthetic premedication in the pediatric settings. The aim of this study was to compare oral midazolam (0.5 mg/kg), which is considered gold standard with oral clonidine (5 mcg/kg) as a premedication in pediatric patients.
  
  
  METHODS
  Sixty children classified as American Society of Anesthesiologists physical status I, aged between 2 and 12, who were scheduled to undergo an elective surgery, were enrolled for a prospective, randomized, and double blind controlled trial. They received either oral midazolam (Group M) or oral clonidine (Group C) 60 minutes before induction of anesthesia and were submitted to an evaluation of anxiety and sedation scores. We also evaluated secondary outcomes such as palatability, parental separation, effect on hemodynamic status, co-operation during venipuncture and facemask application, postoperative analgesic requirement, and recovery profile.
  
  
  RESULTS
  Oral midazolam had better efficacy in the preoperative period as sedative and anxiolytic (P < 0.001), allowed better cooperation during venipuncture and facemask application (P < 0.001), whereas, oral clonidine provided better palatability (P < 0.001), parental satisfaction (P < 0.001), stable perioperative hemodynamics (P < 0.001), better postoperative analgesia (P < 0.001), and night sleep pattern (P < 0.05) without any noticeable side effects (P > 0.05).
  
  
  CONCLUSIONS
  We conclude that under the conditions of this study, oral midazolam is a better medication than clonidine in children in preoperative period while clonidine is a better medication postoperatively with added advantage of palatability, hemodynamic stability, and no significant side effects.
authors.affiliation: Department of Anesthesia and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Sahoo
authors.affiliation: Department of Anesthesia and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Manpreet
authors.initials: M
authors.lastname: Kaur
authors.affiliation: Department of Anesthesia and Critical Care, Maharaja Krishna Chandra Gajapati Medical College, Berhampur University, Odisha, India.
authors.forename: Hemant Kumar
authors.initials: HK
authors.lastname: Tripathy
authors.affiliation: Department of Anesthesia and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ajeet
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Anesthesia and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Santavana
authors.initials: S
authors.lastname: Kohli
authors.affiliation: Department of Anesthesia and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Samridhi
authors.initials: S
authors.lastname: Nanda
keywords: Anxiolytics; oral clonidine; oral midazolam; pediatric anesthesia; premedication; sedation