SUMMARY

This study was conducted in the department of anesthesiology and critical care at the pediatric surgery operating theatre complex, St. John’s Medical College Hospital, Bangalore.

            In this study, 104 ASA grade I and II children between 2-10 years, who were scheduled for elective surgical procedures were observed. The patients that received intranasal Dexmedatomidine (1µg/kg) were allotted to group D and the patients that received intranasal Midazolam (0.2mg/kg) were put under group M.

            30 minutes after premedication with the intranasal drug, the Parental Separation Anxiety Score was assessed on a 4 point scale and sedation of the child was assessed using a 6 point Modified Observer’s Assessment of Alertness/Sedation Scale. Prior to anesthesia induction the Mask Acceptance Score was assessed using a 5 point scale.

            There was a marked variation between the two groups with regards to the parental separation. There was a statistically significant data which concluded the children premedicated with intranasal Dexmedetomidine separated much more easily than those premedicated with intranasal Midazolam.

            The Modified Observer’s Assessment of Alertness/Sedation scores showed a significantly better score in the Dexmedetomidine group compared to Midazolam, indicating a better degree of sedation among those premedicated with Dexmedetomidine.

            There was a statistically significant difference with respect to mask acceptance before induction of anesthesia. The patients premedicated with intranasal Dexmedetomidine had better mask acceptance compared to those premedicated with intranasal Midazolam.

            The demographic data recorded found no difference in the age or gender between the two groups.

            After premedication the children were monitored for 30 minutes at every 10 minute interval, prior to induction of anesthesia. Vital signs (heart rate, BP, respiratory rate and oxygen saturation) were recorded. After administering intranasal premedication it was found the there was a fall in heart rate, without significant fall in blood pressure in the patients who were administered Dexmedetomidine. There was no change in the respiratory rate or oxygen saturation.

            Intra-operatively, the vitals were monitored every 5 minute interval for 30 minutes and thereafter every 10 minutes till the end of the procedure. The intra-operative period showed no significant variation in the vital parameters between the two groups.

            Post operatively the children were monitored for 24 hours after the procedure. The vitals were stable and there were no adverse reactions in any of the children.

Therefore, based on these results it can be concluded that intranasal Dexmedetomidine (1 µg/kg) is more efficacious than intranasal Midazolam (0.2 mg/kg) for premedicating children undergoing short elective surgical procedures.