Atomised intranasal midazolam spray as premedication in pediatric patients: comparison between two doses of 0.2 and 0.3 mg/kg

• Published in: Journal of anesthesia 2012-06, Vol.26 (3), p.346-350
• Main Authors: Baldwa, Namita M., Padvi, Amit V., Dave, Nandini M., Garasia, Madhu B.
• Format: Article
• Language: English
• Subjects: Administration, Intranasal; Anesthesiology; Child; Child, Preschool; Children; Comparative analysis; Critical Care Medicine; Emergency Medicine; Female; Health aspects; Humans; Hypnotics and Sedatives - administration & dosage; Hypnotics and Sedatives - adverse effects; Hypnotics and Sedatives - pharmacokinetics; Intensive; Male; Medicine; Medicine & Public Health; Midazolam; Midazolam - administration & dosage; Midazolam - adverse effects; Midazolam - pharmacokinetics; Original Article; Pain Medicine; Pediatrics; Preanesthetic Medication
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-012-1341-6

Purpose Midazolam premedication administered by the intranasal route is noninvasive with good bioavailability. Atomised intranasal midazolam spray ensures accurate drug dosage and better patient acceptability, with rapid onset of action and virtually complete absorption. Methods Sixty pediatric patients scheduled for elective surgeries were administered atomised intranasal midazolam. Two doses of midazolam, of 0.2 and 0.3 mg/kg, were compared. Children were observed for achieving satisfactory sedation and separation scores, and face mask acceptance. Results At 10 and 20 min of nasal administration, 70 and 76% of the children, respectively, in the 0.3 mg/kg dose group, while 40 and 63% of the children, respectively, in the 0.2 mg/kg group were adequately sedated. Similarly, at 10 and 20 min after administration, 66.6 and 73.3% of children, respectively, in the 0.3 mg/kg group, and 30 and 60% in the 0.2 mg/kg group were easily separated from their parents. With regard to face mask acceptance, 33.3% of patients in the 0.3 mg/kg group and 16.6% in the 0.2 mg/kg group accepted the mask easily. Conclusion Atomised midazolam at 0.3 mg/kg is safe, and achieves faster sedation and better separation scores as compared to 0.2 mg/kg.