Comparison of intranasal dexmedetomidine and midazolam as premedication in children undergoing cardiac surgeries and procedures

Authors

  • R. Arora Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Author
  • P. Nayar Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Author
  • A. Choudhury Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Author
  • S. Kohli Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Author https://orcid.org/0000-0003-1410-6933
  • H. Savithri Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Author

DOI:

https://doi.org/10.2478/AMB-2025-0002

Keywords:

intranasal, premedication, dexmedetomidine, midazolam, cardiac surgery, paediatric anaesthesia, parental separation, ramsay sedation scale

Abstract

Aims and Objectives. To compare premedication with intranasal dexmedetomidine and intranasal midazolam for their sedative eff ects 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 signifi cantly 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 signifi cantly 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 signifi cant as well as satisfactory sedation, lower levels of anxiety, and better parent separation than intranasal midazolam in pediatric patients undergoing cardiac surgeries.

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Published

21.03.2025

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Section

ORIGINAL ARTICLES

How to Cite

Arora, R., Nayar, P., Choudhury, A., Kohli, S., & Savithri, H. (2025). Comparison of intranasal dexmedetomidine and midazolam as premedication in children undergoing cardiac surgeries and procedures. Acta Medica Bulgarica, 52(1), 7-13. https://doi.org/10.2478/AMB-2025-0002