The comparison of oral midazolam, deksmedetomidine and melatonin premedication in children undergoing chronic oesophageal stricture

Objective: Aim of our study is to compare effect of melatonin, dexmedetomidin and midazolam used for premedication of children patients that endoscopic dilatation is planned because of chronic oesophageal stricture to preoperative activity, anxiety, sedation and response to mask scores with placebo.Material and Method: After getting permit of ethical committee, ASA I-II group, 2-12 years-old 100 children to which surgery was applied because of elective chronic oesophageal stricture were included in our study which is planned by double-blind placebo controlled method. Routine pulse and saturation of peripheral oxygen was monitored in children who were taken to preoperative preparation rooms together with their parents. 0,25 mg or maximum 3 mg melatonin (in 1 ml paracetamol syrup), 2,5 µg/kg dexmedetomidin (in 1 ml paracetamol syrup), 5 mg/kg midazolam (in 1 ml paracetamol syrup) and placebo (1 ml paracetamol syrup) were administered in a randomized manner as premedication 40 minutes before starting to general anesthesia induction with standard anaesthetic method. Activity, anxiety, and sedation scores of children were assessed 10, 20, 30, 40 minutes after administration of premedication and scores of response to mask was recorded after anesthesia induction.Results: Decrease of preoperative anxiety and activity scores, increase of sedation scores, more easy fitting to mask, providing of more stable hemodynami were determined than placebo in doses applied midazolam, dexmedetomidin and melatonin administered orally in children. It was determined that best group is melatonin group, and that best group who provides response to mask is dexmedetomidin when activity, anxiety and sedation scores are considered. It is determined that there is no serious side effect in doses applied in all groups incl. placebo and that discharge periods are not affected.Conclusion: It is decided that oral dexmedetomidin, midazolam and melatonin decrease preoperative anxiety, that oral melatonin can be used in safety manner, and that it is a good alternative for dexmedetomidin and midazolam in pediatric cases.