Comparison of Intranasal Midazolam versus Dexmedetomidine as Premedication in Paediatric Patients: A Prospective Observational Study

Abstract

Preoperative anxiety is common in paediatric patients and frequently precipitates emotional distress, difficult parental separation, and adverse perioperative events. An ideal premedicant should provide rapid, atraumatic sedation without causing respiratory or hemodynamic compromise. While intranasal midazolam is widely used, its acidic formulation often causes nasal irritation and paradoxical agitation. Intranasal dexmedetomidine induces cooperative sedation mimicking natural sleep. This study was undertaken to compare the clinical efficacy of intranasal dexmedetomidine versus intranasal midazolam regarding sedation level, parental separation, and mask acceptance, along with perioperative hemodynamics and adverse effects in paediatric patients.