Midazolam Sedation in Paediatrics: Comparative Study of Intranasal Versus Sublingual Midazolam Atomizer Spray in Paediatric Patients Undergoing Magnetic Resonance Imaging

Abstract

INTRODUCTION: Magnetic Resonance Imaging (MRI) causes a great amount of anxiety to both parents and child. Fear of unpleasant procedures and separation from parents may result in lasting and untoward psychological consequences in children. So sedation and anxiolysis is required for children undergoing even for minor diagnostic procedures. OBJECTIVES: The objectives of our study was to compare safety, onset of sedation, degree of sedation produced by intranasal and sublingual administration of midazolam for premedication in children of 4-10 years undergoing MRI. MATERIALS AND METHODS: In this prospective randomized double blind study, the intranasal and sublingual administration of midazolam in pediatric patients who were to undergo MRI was evaluated in 60 children who were aged between 4-10 years with ASA physical status I and II by using a newer midazolam spray. The patients were divided into two groups of 30 patients each and they received Midazolam 0.3 mg/kg. Either intranasally or sublingually in a randomized manner. The heart rate, oxygen saturation (SPO2), respiratory rate and the degree of sedation before and at 3 minutes intervals, recovery score, MRI image quality were recorded and compared. RESULTS: The respiratory rate, heart rate and the oxygen saturation was found from the baseline in both the groups (p >0.05). A sedation score of >3 (approx.) was achieved in both the groups within 10 minutes of drug administration. The recovery score did not differ significantly between the two groups (p >0.05). CONCLUSION: Both the intranasal and sublingual administration of Midazolam as sedative is safe and equally effective in pediatric patients.