Evaluating the Comparative Efficacy of Midazolam and Clonidine as Premedication Agents: Assessing Heart Rate Response and Anti-Sialogogue Effect in Patients Undergoing General Anesthesia

Abstract

Aim and Objectives: The present study aimed to compare the efficacy of oral premedication with midazolam and clonidine in patients undergoing general anesthesia for various surgeries. The study evaluated the age distribution of patients, heart rate response following induction and intubation, and the anti-sialogogue effect of the two medications. Materials and Methods: This randomized, interventional, single-centered study was conducted at Sadar Hospital, District of Chuadanga, Bangladesh, from August 2022 to January 2023. A sample size of 50 patients was included, with 25 patients in each group. Age distribution analysis revealed similar patterns in both groups, with a higher concentration in the middle-age ranges. Following induction and intubation, Group M (midazolam) exhibited significantly higher heart rates compared to Group C (clonidine). Group M also had a lower incidence of dry mouth, indicating a more effective anti-sialogogue effect compared to Group C. Results: In our study, which included 50 patients divided into Group M and Group C, we found significant differences in heart rate response following induction and intubation. Group M exhibited higher heart rates compared to Group C, with mean values of 79±7.2 bpm and 78±4.7 bpm, respectively. These differences were statistically significant (p < 0.001). Moreover, the evaluation of the anti-sialogogue effect revealed that Group M had a significantly lower incidence of dry mouth compared to Group C, with only 3 patients experiencing dry mouth in Group M compared to 23 patients in Group C (p < 0.001). These results indicate that midazolam premedication leads to a stronger cardiovascular response and a more effective reduction in dry mouth symptoms compared to clonidine. These findings emphasize the importance of selecting the appropriate premedication to optimize patient outcomes during general anesthesia. Conclusion: The study highlights the importance of considering the specific premedication agents used in patients undergoing general anesthesia. While midazolam may provide better sedation and anti-sialogogue effects, it should be administered cautiously due to its impact on heart rate. Clonidine may offer advantages in terms of hemodynamic stability but may be associated with a higher incidence of dry mouth. The findings provide valuable insights for anesthesiologists in selecting appropriate premedication to optimize patient care and improve perioperative outcomes.