EVALUATION OF INTRANASAL MIDAZOLAM AS PREANESTHETIC MEDICATION FOR BRIEF PEDIATRIC SURGICAL PROCEDURES

Abstract

Background: Operation theatres environment, surgery and anesthesia causes stress and anxiety. This can cause psychological disturbances especially in children. Sedative and anxiolytic premedication have been used to prevent such outcomes.Intranasal route is least traumatic and easily accepted.Intranasal midazolam has been used for premedication in children. Objectives:The study was undertaken to evaluate the efcacy of intranasal midazolam as premedication with regard to degree of sedation,ease of parental separation, response to venepuncture,response to induction,post anesthesia recovery charecteristics and side effects if any. Methods: A prospective comparative study was conducted in the Department of anesthesia viswabharathi medical college penchikalapadu, kurnool from November 2021 to may 2022 children aged between 3 - 6 years, of either sex belonging to ASA Grade I & II posted for elective surgeries were selected randomly and prospective study was done by dividing them into 3 groups. Group NS: Children received 4.mI/kg of Normal Saline ,Group M1:Children received 0.2mg/kg of intranasal midazolam, Group M2: Children received 0.3mg/kg of intranasal midazolam. The statistical software, namely SPSS 16.0 and WINKS SDA 6 were used for the analysis of the data and Microsoft Word and Excel have been used to generate graphs, tables etc. : All the groups were comparable in age,sex,weight and ASA distribution.In midazolamResults M1 group 24(80%),in M2 group 22(65%) the children were dated.In midazolam M1 group,at 10minutes,parental separation in 27(90%).In M2 group,parental separation in 25(75%) children was much easier compared to 4(13.3%) in NS group.Response to venepuncture was more satisfactory in both midazolam groups than normal saline. Response to mask placement was also good in midazolam groups. There was no undue prolongation of recovery time in all the groups. : The study shows that intranasal midazolam 0.2mg/kg administered 15min prior toConclusion induction in children of 3-6years of age produces satisfactory level of sedation,ease of separation from parents, decreased discomfort associated with venepuncture with better mask acceptance. No signicant hemodynamic changes throughout the procedure.