A Comparison of Intranasal Dexmedetomidine and Intranasal Midazolam for Premedication in Children Undergoing Elective Surgeries

Dr. Sobhan Aich, Dr. Charuta Gadkari, Dr. Anjali Bhure, Dr. Ravi Nikhade

Abstract: Relieving pre-operative anxiety is an important concern for anaesthesiologists in case of children and it is a challenging problem. If not managed in a considered and structured fashion, it can lead to distress for the child, parents, and the operating theatre staff involved. Midazolam has been the most widely used sedative agent, with a long history of safety and efficacy. But it has side effects such as restlessness, paradoxical reaction, cognitive impairment, amnesia, and respiratory depression. Paradoxical reactions can result in a restless and agitated child. Dexmedetomidine is a new potent and highly selective -2 adrenoreceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties, which has been described as a useful and safe adjunct in many clinical applications. It provides a unique conscious sedation (patients appear to be asleep, but are readily roused), analgesia, without respiratory depression. In our study children who were premedicated with intranasal Dexmedetomidine ( 1g/kg) were more significantly sedated at the time of parental separation, at mask acceptance as compared to Midazolam (0.2mg/kg), and was comparable at venipuncture.

Keywords: intranasal, dexmedetomidine, premedication, venipuncture, children