Abstract

Introduction: Surgery and anaesthesia induce considerable emotional stress upon children. Premedicant should relieve this anxiety and facilitate smooth induction. Intranasal route is preferred, as it is noninvasive and more convenient with high bioavailability.

Aim: To compare the efficacy of intranasal ketamine and Intranasal midazolam for paediatric premedication.

Method:  In this prospective, randomised controlled trial 100 patients of 1 to 10 years of age of either sex belonging to ASA class 1 and 2 undergoing various elective surgery were divided into two groups. Group-M received 0.2 mg / kg intranasal midazolam, group-K received 5 mg/kg intranasal ketamine 45 minutes prior to induction .Onset of sedation, degree of sedation, parent separation anxiety scale, acceptance of mask and venipuncture score were assessed.

Results: The mean time of onset of sedation was faster in Group M (10.4±1.5 Vs 15.58±2.18) which was statistically significant (P<.0001). Mean sedation score was lower in group M (2.86±0.99 Vs 3.14±1.1) which was statistically insignificant (P=0.17). The mask acceptance was better in group M (1.32±0.5 Vs1.66±0.6) which was statistically significant (P =0.003).The mean venipuncture score was lower in group M(2.22±0.68 Vs 2.34±0.7) which was statistically insignificant (P=0.4).The mean parental separation anxiety score was lower in group M (2.48±0.97 Vs 2.9±1.1) which was statistically insignificant (P =0.05).

Conclusion: Intranasal midazolam group had faster onset of sedation and better mask acceptance than intranasal ketamine. Both groups were comparable in terms of degree of sedation, parent separation anxiety and venipuncture score.