INTRANASAL PREMEDICATION WITH DEXMEDETOMIDINE AND MIDAZOLAM IN OPHTHALMIC SURGERY FOR PEDIATRICS, ARE THEY REALLY EQUALLY EFFECTIVE?

Introduction: Excessive anxietyhas a bad implication on anestheticpractice in pediatric anesthesia,that is why to decrease anxiety bypremedication is an important issue.Intranasal administration of variousdrugs is an easy route with rapidonset of action allowing administration of a variable drugs such asMidazolamand Dexmedetomidineusedin pediatric preoperative sedation.Methodology: 64 children whowere submitted for elective ophthalmicsurgeries received either 0.5 mg/kgmidazolam or 1µg/kgdexmedetomidineintranasally. Basal heart and respiratory rate, blood pressure,sedation score and oxygen saturationwere recorded initially and every5minutes till the transfer to the operatingroom. Sedation score was alsoassessed at 30 minutes after drugadministration.Postoperative monitoringwas continued and any postoperativecomplications were recorded.Results: Oxygen saturation, heartrate, systolic blood pressure and respiratoryrate values showed insignificantdifferences when both groupswerecompared together, butshowedsignificance differenceswhencompared with the basal valueineach group separately after 30 minutes. Sedation score was fasterand child-parents separation scorewas higher in dexemedetomidinegroup when compared with midazolamgroup, also both groups showedsignificantsedation score less than 3whencompared with the basal valueat15,20,25,30 minutes . Conclusion: Midazolam and dexmedetomidinewere nearly equallyeffectiveas intranasal premedicationforpediatric patients submitted forophthalmicsurgery with minimal sideeffectsand we recommend the useofmidazolam due to its safety andeffectiveness and low price .