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randomize the patients, comparison between the drugs
is flawed, but no failed sedations occurred in the DEX
patients, and no adverse events with clinical relevance
were observed. Parent satisfaction, although not directly
measured by Neville et al.,
1
was also greater with IN DEX.
One concern with the study conducted by Neville et al.
1
was that the anxiety score at positioning for procedure of
the patients receiving DEX was 9.2 points lower than that
of the patients receiving midazolam, according to the mod-
ified Yale Preoperative Anxiety Scale, which the authors used
as a reference. Although other baseline characteristics between
the two groups (DEX and midazolam) were similar, these
randomfindings can cause a potential bias to the final con-
clusions. Despite probably being a better sedative thanmid-
azolam, one could conclude that DEX performed better in
these patients because of their baseline anxiety conditions.
I believe that larger studies with INDEX as premedica-
tion are needed in order to find the better option for pedi-
atric anxiolysis. The article fromNeville et al. substantiates
the indication of IN DEX as a sedative of choice, with min-
imal adverse events and good parent and staff satisfaction.
C
onflict
of
interest
The author declares no conflict of interest.
R
eferences
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