Pre-induction sedation with intranasal midazolam in children

ABSTRACT

Surgical procedures are one of the most stressful experiences in life, especially in children, and different methods are used preoperatively to decreasing this stress. Intranasal midazolam is an effective method for preparing the children before operation and prevents separation irritability. Sixty patients aged 2-6 years that have elective surgery for the first time were chosen randomly. Subjects were randomly allocated into two groups. For the patients in group 1, intranasal midazolam [0.2 mg/kg] and for the patients in group 2, the equal volume of normal saline 0.04ml/kg was administered intranasally. Patients' cries, irritability, hand moving during IV canulla insertion, consciousness before anesthesia and cooperation during face mask ventilation were evaluated. In group 1, 93.3% of children did not cry or cried mildly when separated from parents, 90% of children in group 2 cried moderately or severely [P<0.05]. Ninety percent of patients in group 1 cooperated well, but resistance was moderate or severe in group 2 [76.6%] [P<0.05]. Before anesthesia 73.4% of patients in group 1 were asleep, but woke up with stimulation. In contrast, 63.3% of patients in group 2 were awake and 30% of patients were irritable [P<0.05]. Ninety percent of patients in group 1 moved their hands slightly during IV canulla insertion but hand moving was exaggerated in 83.3% of patients in group 2 [P<0.05]. All patients in group 1 cooperated well during face mask ventilation but 76.6% of patients in group 2 refused it [P<0.05]. The results of the present study suggested that intranasal midazolam was an effective drug for pre-induction sedation in children