Comparison Hemodynamic Effects of Midazolam and Dexmedetomidine as a Premedication in Patients Undergoing Upper Limb Surgeries: A Double-blind Intervention

Premedication is an integral part of general anesthesia which has side effects. The aim of this study was to compare the hemodynamic effects of Dexmedetomidine and Midazolam as a premedication in patients undergoing elective upper limb surgery during induction of anesthesia and postoperative shivering.

60 candidates for elective upper limb surgery who referred to Shahid Rajaee hospital were studied with the double-blind clinical trial method. Patients were randomly divided into two groups, included: 1. Midazolam and 2.Dexmedetomidine. SPO2, MAP, Heart rate, Systolic, and Diastolic blood pressure and postoperative shivering were evaluated at; early entrance time, before induction, 1, 5, 10 minutes after intubation, Post-extubating and recovery in all patients as well as post-surgery shivering. The collected data were analyzed using Chi-square, ANOVA and GLM Repeated Measure by using SPSS 19 software. The P < 0. 05 was considered as the significance level.

At all times, the mean SPO2 was significantly higher in Dexmedetomidine than in the Midazolam group, which was significant at 10 minutes after intubation (P < 0.001). Mean MAP, Heart rate, Systolic and Diastolic blood pressure were significantly further in Midazolam group than Dexmedetomidine group at all times. Postoperative shivering in patients with Dexmedetomidine was significantly lower than the Midazolam group (P < 0.001).

The results showed that Dexmedetomidine has a better hemodynamic control during anesthesia. It also reduces the incidence of postoperative shivering.