Анестезия и клинические исследования
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Dexmedetomidine versus Midazolam as Premedication in Anesthesia: A Meta-Analysis from Randomized Controlled Clinical Trials

Chuixian Zhou and Junhui Zhao

Dexmedetomidine [Dex] is an α2-adrenoceptor agonist which provides sedation, analgesia and anxiolytic effects, thus making it a potentially useful anesthetic premedication. A number of clinical trials have been conducted to compare the sedative effect of Dex versus midazolam [Mdz], a conventional sedative agent in anesthesia. Nevertheless, consensus has not been achieved on which agent is superior to the other in terms of the overall benefit to patients. In this study, we have isolated four independent studies containing randomized, controlled, clinical trials on patients and compare the efficacy and safety of these two agents as a premedication in anesthesia. In the studies of the catheter ablation of atrial fibrillation and surgical correction of scoliosis deformities, Dex treatment resulted in a better sedative and analgesic effects, reflected by a reduced pain, a lower dose of analgesic agents required, and greater sedation scores than Mdz treatment. Similarly, intranasal Dex premedication in the children’s dental rehabilitation and adenotonsillectomy, Dex also yielded a better efficacy. Taken together, Dex provides an improved premedication for sedation and analgesia, as well as the protective effects on the end organs. This study has provided evidence for optimized sedation protocol in anesthesia.