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Category: Volume 07 Issue 06 June 2019
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Title: Premedication with Midazolam in Children: A Randomised Control Study between Oral and Intranasal Routes

Authors: Dr Neetika Mishra M.D, Dr Mhonbemo Khuvung M.D, Dr Sunil Kumar Sah, Dr Ahito kibami M.B.B.S

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.49

Abstract

Introduction

Children posted for surgery are often anxious and uncooperative due to the anticipation of pain, unfamiliar environment, parental separation and fear as a result of previous unpleasant experiences(1). It is always an emotionally stressful and difficult moment for both the child and the mother. Anxiety in children undergoing surgery is characterized by the subjective feeling of tension, apprehension and nervousness. Anxiety is seen in almost all the paediatric patients. 

Preoperative anxiety stimulates the sympathetic nervous system and endocrine system leading to an increase in the heart rate and blood pressure which reflects the fear and anxiety of a child from parental separation, physical harm, surgical instruments and hospital procedures. This may lead to post-operative psychological and behavioural problems, such as new onset enuresis, feeding difficulties, apathy, withdrawal, and sleep disturbances (2).  Separation anxiety usually begins at 7-8 months of age and peaks around 1 year of age. The extent of trauma or adaptive responses depends on the child’s developmental age, parenting experiences, genetic endowment, and environmental stability.  The intensity of separation anxiety declines with age.

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Corresponding Author

Dr Neetika Mishra M.D

Associate Professor, Dept. of Anaesthesiology, North Bengal Medical College, Darjeeling, West Bengal