Background: The study aim was to compare the efficacy of dexmedetomidine versus midazolam for
sedation during the early postoperative period in children who underwent scoliosis surgery.
Methods: We performed a prospective, randomized trial in an intensive care unit (ICU) in a
tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical
status I and II) who underwent scoliosis surgery were divided into 2 groups according to
sedation protocols: group DEX (n = 22) and group MDZ (n = 20). Children (12-18 years)
requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine
(group DEX; starting dose, 0.4 μg•kg-1•h-1) or midazolam (group MDZ; starting dose, 0.1
mg•kg-1•h-1) with intermittent fentanyl, as needed. The efficacy of sedation was assessed
using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using
the Numeric Visual Analog Scale (NVAS). During the arousal assessment, delirium was
determined in patients in the RASS range of -2 to +1 using the Confusion Assessment Method
for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and
hemodynamics were recorded postoperatively at 2, 4, 6, and 24 h in the ICU.