Comparison of intranasal dexmedetomidine and midazolam as premedication in pediatric surgical patients: A prospective, randomized double-blind study

Introduction: To relieve anxiety and fear is a major concern for pediatric anesthesiologist, and intranasal dexmedetomidine seems to be better alternative to midazolam to provide sedation and allay anxiety in children. Aims and Objectives: We compare the sedative effects, anxiety level, successful child–parental separation, and hemodynamic parameters of either intranasal dexmedetomidine or midazolam as a premedication in children undergoing pediatric surgery. Setting and Design: This is a prospective, randomized, double-blind study conducted on 60 patients belonging to the American Society of Anesthesiologists Physical Status Classes I and II, undergoing pediatric surgical procedures with the use of intranasal dexmedetomidine and midazolam as premedication. Materials and Methods: Sixty children were randomly allocated into two groups of 30 each: dexmedetomidine group received intranasal dexmedetomidine (1 μg.kg−1), and midazolam group received intranasal midazolam (0.2 mg.kg−1), 30 min before induction. The sedation score, anxiety score, and successful child–parent separation were recorded till 30 min of drug administration, and then, the child was taken to the operating room (OR). Statistical Analysis: The Statistical Software, namely Statistical Package for the Social Science 17.0, was used for the analysis of the data. A P < 0.05 was considered statistically significant. Results: Children premedicated with intranasal dexmedetomidine achieved significantly lower sedation score (P < 0.001), lower anxiety levels (P = 0.001), and easier child–parent separation (P = 0.003) than children who received intranasal midazolam. Conclusion: Intranasal dexmedetomidine was associated with lower sedation levels, lower anxiety levels, and easier child–parent separation at the time of transferring patients to the OR than children who received intranasal midazolam.