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Comparative evaluation of atomized intranasal midazolam and intranasal ketamine as sedative premedication in children for child-parent separation

Background: In this study we wanted to compare intranasal atomized spray of midazolam 0.5 mg/kg with ketamine 5 mg/kg, as sedative premedicants for a child patient to treat separation anxiety in paediatric surgical procedures with regard to the quality and rate of onset of sedation, sedation score, and behaviour score at the time of separation from parents and during gas induction of anaesthesia. we also wanted to compare any perioperative adverse effects of the premedication like airway obstruction, desaturation, bradycardia, sneezing, vomiting etc., acceptance of nasal spray and any delay in recovery from anaesthesia. Methods: This prospective study was undertaken in 60 paediatric patients aged between 1 and 6 years, belonging to both sexes of ASA grade 1 or 2 undergoing elective surgical procedures under general anaesthesia. The study was conducted at Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu. Group 1 received intranasal ketamine 5 mg/kg and Group 2 received intranasal midazolam 0.5 mg/kg. Patient’s heart rate, SpO2, sedation score, behaviour score and any side effects like nausea, vomiting, airway obstruction etc. were noted at 5 min intervals for a duration of 20 minutes.&nbsp