Volume : 7, Issue : 12, December - 2018

A Comparative Study of Intranasal Dexmedetomidine and Intranasal Midazolam as Premedication in Children Undergoing Short Surgical Procedures

Dr. Rahul Fernandez, Dr. Moses Charles Dsouza, Dr. Surbhi Gupta, Dr. Sumithra Selvam

Abstract :

<p>&nbsp;</p> <p class="Default" style="margin-top:12.0pt;margin-right:0in;margin-bottom:10.0pt;&#10;margin-left:0in;text-align:justify;line-height:200%"><b>Introduction :</b><span style="mso-bidi-font-weight:bold"> Anaesthetizing children for surgery can be challenging due to parental separation anxiety and an unfamiliar OT environment. Various drugs have been tried for pre- medication to alleviate this anxiety and facilitate induction of anesthesia. We compared <span style="mso-spacerun:yes">&nbsp;</span>Intranasal Dexmedetomidine and Intranasal midazolam for premedication in children undergoing short surgical procedures.<o:p></o:p></span></p> <p class="Default" style="margin-top:12.0pt;margin-right:0in;margin-bottom:10.0pt;&#10;margin-left:0in;text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="mso-fareast-font-family:AdvTimes">Materials and Methods: </span></b>104, <span style="mso-spacerun:yes">&nbsp;</span>ASA grade I and II children between 2-10 years, scheduled for elective short surgical procedures were randomly allocated to receive intranasal Dexmedetomidine (1&micro;g/kg) (Group D) or intranasal Midazolam (0.2mg/kg) (Group M) . The Parental Separation Anxiety Score, MOAA/S scores ,Mask Acceptance Score and 24 hr vitals were assessed<o:p></o:p></p> <p class="Default" style="margin-top:12.0pt;margin-right:0in;margin-bottom:10.0pt;&#10;margin-left:0in;text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal">Results: </b>The parental separation and<span style="mso-spacerun:yes">&nbsp; </span><a name="_Hlk532416810">MOAA/S scores <span style="mso-spacerun:yes">&nbsp;</span></a>attained with intranasal Dexmedetomidine premedication were found to be superior to intranasal Midazolam (p&lt;0.0001). The mask acceptance was better among children premedicated with intranasal Dexmedetomidine than with Midazolam . There was a statistically significant decline in the heart rate in the group D <span style="mso-spacerun:yes">&nbsp;</span>compared to group M after premedication<o:p></o:p></p> <p class="Default" style="text-align:justify;line-height:200%"><b style="mso-bidi-font-weight:normal">Conclusion: </b>Children premedicated with intranasal Dexmedetomidine separated much more easily from parents with a better degree of sedation and better mask acceptance compared to those premedicated with intranasal Midazolam. <o:p></o:p></p>