Objective: To compare intranasal Midazolam and intranasal Ketamine as a preanaesthetic medication in paediatric surgical patients.

Methods: This was an open label randomized controlled trial study. Children weighing 05-20 kg scheduled for routine surgeries were participated in the study. Children were randomly assigned into two groups: Group M (n=50): Received intranasal midazolam spray in doses of 0.3 mg/kg and Group K (n=50): Received intranasal ketamine in doses 6 mg/kg. Acceptance of drug, response to drug administration, sedation scale, separation score, ease of cannulation score, vital parameters and side effects of drug was noted.

Results: There was no significant (p>0.05) difference in basic characteristics between the groups. There was no significant (p>0.05) difference in baseline hemodynamic parameters between the groups. Moderate fear/crying not quite with reassurance was the most common separation score in Intranasal Midazolam (38%) and Slight fear/crying quite with reassurancewas the most common separation score in Intranasal Ketamine (42%). Good acceptance of cannulation score was among more than half of patients in both Intranasal Midazolam (44%) and Intranasal Ketamine (70%). Hypotension was the most common side effect in both the groups constituting 8%.

Conclusion: Preanaesthetic medication with intranasal ketamine and intranasal midazolam are both equally effective for the purpose of sedation. Intranasal ketamine achieved better quality of sedation enabling easier parental separation. This study found that intranasal route was convenient and safe route for premedication in children.

Keywords: Preanaesthetic medication, Intranasal Midazolam, Intranasal Ketamine.

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Dr Abhishek Tiwari

Assistant Professor, Department of Anaesthesiology, Integral Institute of Medical Sciences and Research, Kursi Road, Lucknow