Author(s): P. S. Arunalatha1, M. Umamaheswar2
Intranasal midazolam has been used for premedication in children. To evaluate the efficacy of intranasal midazolam as premedication with regard to degree of sedation, ease of parental separation, response to venipuncture, response to induction, post anaesthesia recovery characteristics and side effects if any. 90 patients in the age group of 3-6 years of either sex belonging to ASA grade I and II posted for elective surgery under general anaesthesia were studied. The patients in group M1 (midazolam) received 0.2 mg/kg of intranasal midazolam. The patients in group M2 (midazolam) received 0.3 mg/kg of intranasal midazolam and patients in group NS (normal saline) received 0.04 ml/kg of normal saline. At 5minutes after administration of the drug degree of sedation was assessed. The patients were followed up for 24 hours post operatively. In midazolam M1 group, 24(80%) inM2 group 22(65%) the children were satisfactorily sedated at 5min after administration of the drug where as in normal saline group only 15(50%) were satisfactorily sedated. In midazolam M1 group, at 10 minutes, parental separation in 27(90%) inM2 group, parental separation in 25 (75%) children was much easier compared to 4 (13.3%) in NS group. Response to venipuncture was more satisfactory in both midazolam groups than normal saline. There was no undue prolongation of recovery time in all the groups. The study shows that intranasal midazolam 0.2 mg/kg administered 15 min prior to induction in Children of 3-6 years of age produces satisfactory level of sedation, ease of separation from parents, decreased discomfort associated with venipuncture with better mask acceptance.