Indian Journal of Anaesthesia (Jan 2007)
Evaluation of intranasal midazolam for preanasthetic sedation in paediatric patients
Abstract
Most of the preschool children suffer from severe anxiety and apprehension before operation. This can largely affect the smooth conductance and emergence from anaesthesia. Above all this can lead to development of maladaptive behavioral responses in later part of life. Midazolam in current time has emerged as an ideal premedicant having all the desirable properties in this regard. It has been used by several routes for premedication. Each has its own advantage and disadvantage. The search for an ideal route and dose still exists. So the current study was planned to find out the efficacy of midazolam intranasally. Forty five paediatric patients of 2-5 years of age belonging to ASA I& II, scheduled for minor elective surgery were selected for this study. Patients were divided in three equal groups to receive normal saline (Group I), 0.2 mgkg-1 midazolam (Group II), or 0.3mgkg-1 midazolam (Group III) intranasally. Vital parameters and level of sedation (using a sedation scale) were assessed before administering the drug and at 5 min interval up to induction of anaesthesia. Standard anaesthesia technique was used intraoperatively. Recovery parameters were assessed in the recovery area using a recovery scale. A statistically significant change in the level of sedation was found at 5 min in group II and at 10 min in group III compared to control group. Parental separation was significantly easier in midazolam groups. Mask acceptance rate was also found to be significantly higher in midazolam groups. There was no statistical difference in recovery parameters in any group. No major adverse effect was seen in any midazolam group. No major advantage was found with higher dose of midazolam. Therefore we conclude that 0.2 mgkg-1 intranasal midazolam is an effective method of producing anxiolysis and sedation in paediatric patients.
