A comparative study of intranasal midazolam spray and oral midazolam syrup as premedication in pediatric patients

Abhishek, Rahul; Sharma, Ankita; Ganapathi, P; P, Shankaranarayana; Aiyappa, D S; M, Nazim

doi:10.4103/2394-6954.180661

Cited by 4 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As per results, Group M achieved superior and faster sedation levels than Group C. This rapid onset of intranasal midazolam can be attributed to pharmacokinetic properties of midazolam where it is rapidly absorbed from highly vascular nasal mucosa into the systemic circulation, firstpass hepatic metabolism is bypassed and therapeutic plasma and Cerebrospinal Fluid (CSF) concentrations are achieved 12,13,15,[17][18][19][20] Regarding child-parent separation, the scores are better with Group M than with Group C. In our study mean separation scores were 1.28 ± 0.60 in midazolam group, which is comparable with studies by Ramesh Koppal et al and Anisha AC et al 6,17 About 89.74% children in midazolam group had satisfactory mask acceptance in our study, which is consistent with studies by Bhakta et al, 21 Ravi Verma et al, 12 Sneha P et al 19 and Abhishek et al 22 A study by Mitra S et al showed 100% good mask acceptance with intranasal clonidine. 1 But in our study, only 66.66% children on clonidine had satisfactory mask acceptance.…”

Section: Discussionsupporting

confidence: 91%

Is Atomized Intranasal Midazolam a Novel Sedative Premedication in Paediatric Patients?

Kabade¹,

S.L²,

Wilson³

2017

jebmh

View full text Add to dashboard Cite

BACKGROUND The successful conduct of anaesthesia in children depends on adequate premedication, which not only comforts the anxious child but also comforts the parents or guardians. Atomized Intranasal Midazolam is quickly absorbed through the nasal mucosa, resulting in a rapid and reliable onset of action. Clonidine has several applications in paediatric anaesthesia as a premedication and as an adjuvant in general as well as regional anaesthesia. Thus, in search of a novel premedication technique, we conducted a study to compare the effectiveness of atomized intranasal midazolam with intranasal clonidine for preoperative sedation in paediatric patients undergoing elective surgery. MATERIALS AND METHODS After obtaining Institutional Ethical Committee clearance and parent's consent, a prospective, randomised, double-blinded clinical study was conducted in 78 children of ASA I and II, belonging to 2-10 years age, posted for various elective surgery. Group M (n= 39) received atomized intranasal midazolam (0.3 mg/kg) and Group C (n= 39) received clonidine (4 mcg/kg) instilled into both the nostrils. Sedation score (Ramsay), separation score, mask acceptance, recovery and vital parameters were recorded. Statistical analysis of data was done using IBM-SPSS version 21.0. RESULTS Mean sedation scores (± SD) were higher in Group M than in Group C (at 5th minute 1.58 ± 0.55 in Group M and 1.15 ± 0.36 in Group C with P= 0.002, at 10th minute 2.34 ± 0.97 in Group M and 1.75 ± 0.71 in Group C with P= 0.008). Separation scores and mask acceptance were better with Group M than Group C. Haemodynamic parameters were similar in both the groups and no major adverse effects were noted. CONCLUSION Atomized intranasal midazolam produces superior sedation levels, child-parent separation and mask acceptance compared to intranasal clonidine in children.

show abstract

Section: Discussionsupporting

confidence: 91%

Is Atomized Intranasal Midazolam a Novel Sedative Premedication in Paediatric Patients?

Kabade¹,

S.L²,

Wilson³

2017

jebmh

View full text Add to dashboard Cite

show abstract

“…Similar to the present study, Raval and Gunga[17] also found higher scores for nasal (3.06) as compared to oral (2.96) but found the difference to be much lower (0.1) that observed in the present study (1.03). Abhishek et al [18] in their study while using a different scoring system for sedation, also found the performance of nasal group to be better than oral group (86% vs. 83%) but did not find a significant difference between two groups. However, Nainegali et al [19] also reported results comparable to the present study and reported 20-min postadministration sedation scores in nasal group to be significantly higher as compared to that in oral group.…”

Section: Discussionmentioning

confidence: 89%

Comparative study of oral midazolam syrup and intranasal midazolam spray for sedative premedication in pediatric surgeries

et al. 2019

View full text Add to dashboard Cite

Introduction: Midazolam is a water-soluble benzodiazepine which is frequently administered by intravenous and oral routes. Its nasal spray has become recently available. Materials and Methods: In this study, after obtaining clearance from the ethical committe, 66 patients between the age group of 4 and 10 years comparable in demographic variables were randomly allocated into two groups of 33 each. Group “O” received oral midazolam (0.5 mg/kg) 20 min before induction. Group “N” received intranasal midazolam (0.2 mg/kg) 20 min before induction. The heart rate and blood pressure (systolic, diastolic, and mean) and oxygen saturation (SPO 2 ) were recorded. Statistical Analysis Used: The statistical analysis was done using SPSS (Statistical Package for the Social Sciences) version 15.0 software. The values were represented in number (%) and mean±sd. Results: Satisfactory sedation scores were better in nasal spray group than oral group. Satisfactory ease of induction scores, recovery times, and postanesthesia recovery scores were better in the nasal spray group than in the oral group. Conclusion: Nasal midazolam spray is acceptable and is a good alternative to oral midazolam as premedication in the pediatric population.

show abstract

“…Intra nasal midazolam has emerged an excellent alternative to IV, IM, rectal and other invasive routes in children. 3 In this study, Intranasal Midazolam used in dose of 0.3 mg/ kg and 0.5 mg / kg because earlier report suggest that dose less than 0.2 mg / kg was ineffective. 4,5 So we tried to find out which dose gives better effect without any side effect.…”

Section: Discussionmentioning

confidence: 95%

Intranasal midazolam: Sedation for radiological procedures

Oza¹,

Patel²,

Pathak³

et al. 2019

IJCA

View full text Add to dashboard Cite

Preoperative stress, anxiety and lack of cooperative ability of paediatric patients need sedation for radiological procedure. Aims: The purpose of study is to compare and evaluate efficiency and safety of two doses of intranasal midazolam. Settings and Design: This is a prospective Randomized controlled study of interventional type of study. Methods and Material: Sixty patient of age 1 to 4 years, ASA 1 and ASA2 undergoing radiological procedure were randomly divided into two groups. Group A received 0.3 mg/kg and Group B received 0.5 mg/kg of intranasal spray of midazolam. Sedation score, haemodynamic variations, ease of separation, Venepunture response and side effect were studied. Statistical analysis used: Data analysis was performed using SPSS for Windows, version 20.0(SPSS Inc., Chicago, IL) Results: Higher sedation score achieved earlier with 0.5mg/kg dose, Parenteral separation and IV line insertion was more easier with 0.5 mg/kg dose but recovery slight delay compare to 0.3 mg/kg dose after 20 min of procedure completion but there was no much prolongation of recovery time, at 30 min of all patient discharged in both groups. Conclusions: High Sedation score, parentral separation and response to IV line was earlier and easier with 0.5 mg/kg dose. Key Messages: Intranasal Midazolam is safe and effective as sedative in paediatric radiological procedure.

show abstract

A comparative study of intranasal midazolam spray and oral midazolam syrup as premedication in pediatric patients

Cited by 4 publications

References 0 publications

Is Atomized Intranasal Midazolam a Novel Sedative Premedication in Paediatric Patients?

Is Atomized Intranasal Midazolam a Novel Sedative Premedication in Paediatric Patients?

Comparative study of oral midazolam syrup and intranasal midazolam spray for sedative premedication in pediatric surgeries

Intranasal midazolam: Sedation for radiological procedures

Contact Info

Product

Resources

About