ABSTRACT

BACKGROUND: Ensuring adequate preoperative sedation is an essential part of pediatricanesthesia.Children are needle-scared and prefer palatable syrups and drops. New routes of administration are recently formulated of which intranasal route offers good scope for action by virtue of large absorptive mucosal area. In this background this study is undertaken.

AIMS/OBJECTIVES: To compare efficacy of intranasal midazolam and oral promethazine as premedication in children with regard to Pre-induction sedation status, ease of parental separation, ease of induction, post-operative recovery characteristics & Side effects/complications.

METHOD: we selected 60 ASA I & 2 children undergoing elective surgery at ESIC-PGIMSR, Bangalore & randomly divided them into 2 groups of 30 each. One group (Group M) received intranasal midazolam spray 0.4mg/kg thirty minutes prior to induction & another group (Group P) received oral promethazine syrup 1mg/kg ninety minutes prior to induction. Study parameters were observed for period of 30 minutes prior to induction.

RESULTS: Both group had comparable Heart rate, SBP, DBP, RR, SPO2& sedation scores at all the point of assessment (p>0.05). However onset of sedation was 9.67±1.15 mins(group M) & 61.70±1.88 mins(group P); mean mask acceptance score was4.4±0.62(group M) & 3.5±0.51(group P) p<0.001; Parental separation was excellent in 90% (group M) 50% (group P)p=0.003.

CONCLUSION: We conclude that intranasal midazolam & oral promethazine are effective premedicants for children posted for surgery. However intranasal midazolam is preferred over oral promethazine syrup because of its faster onset of sedation, satisfactory sedation level, ease of parental separation & ease of mask acceptance.