Intranasal dexmedetomidine vs intranasal midazolam for premedication in paediatric patients undergoing surgery under general anaesthesia

Introduction: This prospective, randomized, double-blind study was conducted with an aim to compare the efficacy of intranasal dexmedetomidine and intranasal midazolam as premedication in uncooperative children undergoing elective surgery under general anaesthesia. Materials and Methods: One hundred and twenty children in American Society of Anesthesiology classification (ASA) physical status I & II, in the age group of 2-12 years who were planned to undergo surgery under general anaesthesia, were included in the study and were randomly assigned to one of the two groups. Group D received 1 mcg/kg of IN dexmedetomidine while group M received 0.2 mcg/kg of IN midazolam for premedication. The patient's sedation status, separation anxiety and mask acceptance along with the hemodynamic parameters were noted. Results: Satisfactory sedation was achieved in 56% children in group M and 65% children in group D (p > 0.05). Compared with the children in group M, those in group D had significantly better satisfactory anxiolysis at the time of separation from the parents (56 vs 50; p < 0> Conclusion: Intranasal midazolam and dexmedetomidine are both effective as premedication in children undergoing surgery. However, intranasal dexmedetomidine offers better effect on sedation, alleviating separation anxiety and acceptance of facemask during induction than intranasal midazolam.