STUDY ON COMPARATIVE EFFECTIVENESS OF ORAL MIDAZOLAM VERSUS INTRANASAL MIDAZOLAM AS SEDATIVE PREMEDICATION IN PEDIATRIC SURGERIES: A PROSPECTIVE OBSERVATIONAL STUDY
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Keywords
Surgery and anesthesia, Intranasal midazolam, oral midazolam, distress, children
Abstract
Background: Surgery and anesthesia can cause considerable distress and psychologic consequences for both parents and children. Although it is difficult to determine which components of a child's hospitalization experience result in psychologic problems.
Aim: The aim of the study was to compare the effectiveness of Intranasal and oral midazolam used as a premedication in pediatric patients undergoing elective surgical procedures.
Methods: The study was conducted in “Govt. Medical college Srinagar” which is a tertiary care hospital during October 2020 to December 2022 in ASA 1 children who were scheduled for routine surgeries lasting for <75 minutes on 100 children who were randomly allocated into 2 groups with 50 in each. (Group A and Group B). Group A intranasal and Group B- oral group. Children belonged to age group of 4 to 10 years of both sexes. The parents provided written informed consent before premedication of their children.
Results: Midazolam was used as premedication in intranasal and oral routes in children undergoing surgical procedures and the efficacy of the drug in producing preoperative sedation, anxiolysis and co- operation during separation from the parents, was compared using separate scoring systems. The time of onset of sedation is 11 minutes with intranasal midazolam and 19 minutes with oral midazolam. Intranasal midazolam has more rapid onset of action compared to oral midazolam, which is statistically significant.
The sedation scores are better with intranasal midazolam than oral midazolam at 10 minutes, 15 minutes and 20 minutes which are statistically significant. No patient was over sedated or drowsy postoperatively. No complications were observed in both the groups.
Conclusion: In conclusion, Intranasal midazolam when used as a premedication in children, in a dose of 0.4 mg/kg has more rapid onset of action with good acceptance, satisfactory sedation, separation from parents and ease of induction than oral midazolam.
The rapid onset of action of nasal midazolam makes it an ideal route for premedication in children
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Dr. Mohd. Iqbal Shah
Postgraduate Scholar, Department Of Anesthesiology And Critical Care, Gmc Srinagar, India
Dr. Abraq Asma Riyaz
Associate Professor, Department Of Anaesthesiology, Hamdard Institute Of Medical Sciences And Research, New Delhi.
Dr. Hina Bashir
Professor & Hod, Department Of Anesthesiology And Critical Care, Gmc Srinagar, India.
Dr. Anka Amin
Associate Professor, Department Of Anesthesiology And Critical Care, Gmc Srinagar, India
Sajad Hassan Khan
Postgraduate Scholar, Department Of Anesthesiology And Critical Care, Gmc Srinagar, India