Comparative study of oral and trans nasal midazolam as a sedative premedication in paediatric patients

Background: Premedication in pediatric patient before induction of anaesthesia is of vital importance. Midazolam is a benzodiazepine which produces anxiolytic, amnestic, hypnotic and skeletal muscle relaxant effects. Objectives: To evaluate the safety, acceptability, level of sedation and ease of administration of midazolam by using oral and trans nasal route as a sedative premedication in paediatric patient. Materials and Methods: Sixty paediatric patients of ASA grade I or II, aged 2-10 years, undergoing elective surgery were randomly divided into two groups. Group I received oral syrup midazolam 0.5mg/kg and Group II received nasal spray midazolam 0.25mg/kg. Demographic profile, response to drug administration, level of sedation, separation from parents, venipuncture, induction and postoperative recovery scores were noted and statistically analyzed. Results: The study shows that children receiving oral midazolam has better acceptability (group I, 76.66%) than when administered through intranasal route (group II, 53.33%). Sedation score were better at 20 min. in intranasal group (3.06 versus 2.96) than oral group. Post anesthesia recovery scores were similar in both groups. Conclusion: On the basis of our study, we concluded that oral syrup midazolam has better acceptability while intranasal spray midazolam has slightly faster onset without prolonging recovery from anesthesia.