Comparison of Intranasal Dexmedetomidine and Midazolam as Premedication in Children Undergoing Cardiac Surgeries and Procedures

Abstract Aims and Objectives. To compare premedication with intranasal dexmedetomi-dine and intranasal midazolam for their sedative effects and ease of parental separation in children undergoing cardiac surgeries. Materials and Methods. This prospective, interventional study was conducted on 40 children aged 1-10 years undergoing cardiac procedures, who were randomized into two groups of 20 each. Group D received 2 mcg/kg intranasal dexmedetomidine, and Group M received 0.2 mg/kg intranasal midazolam 30 minutes before the surgery. The sedation levels were assessed by the Ramsay Sedation Scale (RSS), and ease of separation from parents by Child-Parent Separation Score (CPSS) in both groups. Results. The CPSS score was significantly lower with group D as compared to group M (scores 1 vs 2, p = 0.0002 prior to shifting of children to OT). Ramsay Sedation Scale value was significantly higher in group D compared to group M after 15, 25 and 30 minutes (scores 3 vs 2, p < 0.0001). Conclusion. Intranasal dexmedetomidine achieved significant as well as satisfactory sedation, lower levels of anxiety, and better parent separation than intranasal midazolam in pediatric patients undergoing cardiac surgeries.