Comparison of oral premedication of midazolam, ketamine and dexmedetomidine in sedation and facilitation of separation of children from parents for induction of anesthesia

Oral premedication of midazolam, ketamine and dexmedetomidine in sedation and facilitation of separation of children from parents will be compared.

Clinical trial with 3 parallel groups of intervention, double-blind, randomized by block method, phase 3 on 153 patients

In this double-blind randomized clinical trial study, eligible patients in Arak University of Medical Sciences affiliated hospitals, after obtaining informed consent, enter the study and are randomly divided into 3 groups by block method. The drug (midazolam or ketamine or dexmedetomidine) is given by the intern, who is unaware of the type of drug being prescribed, into syringe under the child's tongue to be swallowed with a short pause in the mouth. Sedation score, ease of separation and acceptance of anesthesia drug as well as blood pressure, heart rate, arterial oxygen saturation, time to get Aldrete score 8 and above as well as side effects (nausea and vomiting, hypotension, bradycardia) are recorded and studied.

Age 2 to 7 years Weight between 10 and 30 kg ASA I or II Candidate for elective surgery except for fractures Absence of any fracture operation No history of allergies Absence of liver, kidney and cardiopulmonary disorders Lack of long-term use of anticonvulsant drugs, sleep disorders Absence of speech or communication problems Absence of gastrointestinal disorders (due to oral administration of drugs) The duration of surgery is less than 120 minutes Consent of parents and guardians of the child

Eligible children are randomly divided into 3 intervention groups that will receive orally before the surgery, the first group: midazolam, the second group: ketamine and the third group: dexmedetomidine.

sedation score; Ease of separation score; Acceptance of drug Score - Each based on the relevant table

In this double-blind randomized clinical trial study, 153 patients 2 to 10 years old, candidates for elective surgery, enter the study after obtaining the informed consent of the patient's parents or guardian. None of the children should receive sedatives before entering the operating room and they are randomly divided into 3 groups by block method.

Unaware of the type of drug being prescribed, the intern pours the drug under the child's tongue by the syringe containing the intervention drug to be swallowed with a short pause in the mouth. The exact method is that in each group, after calculating the amount of drug based on the child's weight, to standardize and create an acceptable taste, one milliliter of 20% dextrose solution is added to the calculated intervention drug for each patient. Finally, to match the groups, the volume of the prescribed material with distilled water is increased to 5 ml. This double-blind study will be performed in such a way that patients with informed consent to enter the plan will not be aware of the type of drug used. Also, the intern, who is responsible for completing the questionnaires and recording the data, is not aware of the patients in the study groups and will not be aware of the type of oral solution. And will only complete the questionnaires based on the numbers to be assigned to the operating room by the anesthesiologist in charge of the project.

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