OBJECTIVES: The study aimed at comparing the efficacies of intranasal dexmedetomidine & intranasal midazolam regarding producing sedation at induction. The secondary end- points were preoperative heart rate & systolic bloos pressure changes after administration of either drugs. We also looked at sedation & analgesia status at the time of induction, recovery as well as 3 hours & 6 hours post operatively.

METHODS: Study subjects comprised of children aged 2-8 years posted for elective surgery under general anesthesia. It was a double blind randomized control trial comprising of 90 subjects divided into 2 groups. group A (n=42) received 0.2 μg/kg dexmedetomidine & group B (n=48) 0.5 mg/kg midazolam by intranasal route 45 minutes prior to induction. sedation & analgesia scores were assessed by Ramsay Sedation Scale & Observer Pain Scale respectively. heart rate & systolic blood pressures were recorded every 15 minutes pre- operatively after administration of drugs. sedation & analgesia scores were recorded at induction, recovery, after 3 hours & 6 hours post operatively.

RESULTS: 93% subjects in group A & 60% in group B achieved satisfactory sedation at the time of induction. Sedation status & analgesia obtained at the time of induction, recovery, 3 hours & 6 hours post operatively were significantly better in group A. Pre- operative changes in HR & SBP in both groups were comparable.

CONCLUSION: Intranasal dexmedetomidine is safe &more effective than intranasal midazolam for pre operative sedation in children. Also, intranasal dexmedetomidine is a superior agent than intranasal midazolam for post operative analgesia in pediatric population.