INTRAMUSCULAR MIDAZOLAM AND ORAL CLONIDINE AS A PREMEDICATION IN GENERAL ANAESTHESIA: A COMPARATIVE STUDY

Abstract

Introduction: For anesthesiologists one of the challenges is to minimize psychological scaring and upset in the operating room environment and to facilitate a smooth induction of anesthesia. Anxiety and fear of operation, physicians, injections, parental separation and operation theater environment are all traumatizing experiences in postoperative maladaptive behavioral changes. During induction midazolam used as premedication showed significant reduction in dose, less airway irritability, low maintenance requirements of anesthetics and blood pressure (BP) increase. Preoperative use of clonidine has been shown to potentiate the effects of anesthetics. Midazolam is a benzodiazepine with complete absorption pattern after intramuscular (i.m.) injection and short elimination halflife. Midazolam has property to produce amnesia and Clonidine impaired sympathoadrenal responses to painful stimuli at the time of tracheal intubation or surgery and other stimuli.

Aim: The main aim is to compare the effects of Intramuscular Midazolam and Oral clonidine as premedication.

Material and Method: The present study was carried out in the department of anesthesia at Prakash Institute of Medical Science and Research. Total 50 patients were included in this study with the age range from 15 years to 60 years. Preoperative assessment was carried out of patients one day before operation.  Complete history of the patients was taken and systemic examination was performed to rule out any major systemic dysfunction. Total patients were divided in two groups in which Group I Inj. Midazolam 0.07 mg/kg i.m. was used before surgery whereas in group II 2 hours before surgery orally Tab. Clonidine 4µg/kg was used. At the time of giving premedication blood pressure, Pulse rate, state of excitement, apprehension and sedation were also noted.

Result: In both the cases age group of 16-30 years (56%) have majority. According to gender wise 40% cases were males and 60% were females. Sedation score, apprehension score and excitement score before and after induction was statistically significant (p<0.001). Both midazolam and clonidine caused significant reduction in propofol dose required to induce anesthesia.

Conclusion: In sedative and anxiolytic effects midazolam was found to be superior to clonidine & had better amnesia than clonidine. Dose reduction of propofol was more in clonidine group.

Keywords: Midazolam, Clonidine, Premedication, Sedative