title: Evaluation of intranasal Midazolam spray as a sedative in pediatric patients for radiological imaging procedures.
abstract: BACKGROUND
  Preoperative anxiety and uncooperativeness experienced by pediatric patients are commonly associated with postoperative behavioral problems.
  
  
  OBJECTIVE
  We aimed to evaluate the efficacy and safety of intranasal Midazolam as a sedative in a pediatric age group for radiological imaging procedures and to note onset of sedation, level of sedation, condition of patient during separation from parents and effect on the cardio-respiratory system.
  
  
  METHODS
  Randomized double-blinded study.
  
  
  METHODS
  Fifty patients of the pediatric age group of American Society of Anesthesiologist grade 2 and 3 who came for any radiological imaging procedures were studied. Patients were randomly allocated to receive, intranasally, either Midazolam 0.5 mg/kg (group A N = 25) or normal saline (group B N = 25) in both nostrils (0.25 mg/kg in each) 15 min before the procedure. Time for onset of sedation and satisfactory sedation, sedation score, separation score, hemodynamic changes and side-effects were recorded.
  
  
  METHODS
  Student's t-test.
  
  
  RESULTS
  Intranasal Midazolam group had a significantly shorter time for onset of sedation and satisfactory sedation. Mean sedation score and mean separation score at 10 min and 15 min intervals were significant in intranasal Midazolam as compared with normal saline (P < 0.001).
  
  
  CONCLUSIONS
  Intranasal Midazolam 0.5 mg/kg is safe and effective and provides adequate sedation for easy separation from the parents and reduced requirement of intravenous supplementation during radiological imaging procedures without any untoward side-effects.
authors.affiliation: Department of Anaesthesiology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Anisha A
authors.initials: AA
authors.lastname: Chokshi
authors.affiliation: Department of Anaesthesiology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Vipul R
authors.initials: VR
authors.lastname: Patel
authors.affiliation: Department of Anaesthesiology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Parthiv R
authors.initials: PR
authors.lastname: Chauhan
authors.affiliation: Department of Anaesthesiology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Deep J
authors.initials: DJ
authors.lastname: Patel
authors.affiliation: Department of Anaesthesiology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Indu A
authors.initials: IA
authors.lastname: Chadha
authors.affiliation: Department of Anaesthesiology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Monal N
authors.initials: MN
authors.lastname: Ramani
keywords: Intranasal midazolam; pediatric patient; radiological imaging procedure; sedation