title: Comparison of ease of administration of intranasal midazolam spray and oral midazolam syrup by parents as premedication to children undergoing elective surgery.
abstract: BACKGROUND
  The efficacy of midazolam as premedication in children for providing pre-operative sedation and reducing parental separation anxiety has been well established. Many studies have compared the effectiveness and medication acceptance of midazolam via oral and intranasal routes. In this study, we have compared the ease of administration of oral midazolam syrup and intranasal midazolam spray as premedication, administered by parents to children.
  
  
  METHODS
  Ninety children were randomly allocated into one of the two groups: group N received nasal midazolam spray 0.2 mg/kg and group O received oral midazolam syrup 0.5 mg/kg administered by the parent. The parent recorded ease of administration score and facial hedonic score. The observer recorded modified medication acceptance score. Vitals and sedation scores were assessed at specific intervals. Thirty minutes after drug administration the child was separated from the parent, and parental separation anxiety score was recorded. Mask acceptance score was recorded after application of mask upon arrival in the OT.
  
  
  RESULTS
  Oral midazolam syrup was found to have better ease of administration than intranasal midazolam spray as felt by the parent. Medication acceptance was better for oral midazolam. Both the groups had similar sedation scores at 15 and 30 min. Children in the oral group had a better reduction in parental separation anxiety at 30 min after drug administration and better mask acceptance than the nasal group.
  
  
  CONCLUSIONS
  Oral midazolam syrup is easier for parents to administer and has better medication acceptance in children when compared to intranasal midazolam spray.
authors.affiliation: Department of Anaesthesiology and Critical Care, JIPMER, Pondicherry, India, 605006.
authors.forename: Milthi
authors.initials: M
authors.lastname: Manoj
authors.affiliation: Department of Anaesthesiology and Critical Care, JIPMER, Pondicherry, India, 605006. munaganuri1975@yahoo.co.in.
authors.forename: M V S
authors.identifier: http://orcid.org/0000-0002-1263-038X
authors.initials: MVS
authors.lastname: Satya Prakash
authors.affiliation: Department of Anaesthesiology and Critical Care, JIPMER, Pondicherry, India, 605006.
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Swaminathan
authors.affiliation: Department of Anaesthesiology and Critical Care, JIPMER, Pondicherry, India, 605006.
authors.forename: Rithu Krishna
authors.initials: RK
authors.lastname: Kamaladevi
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D001007:Anxiety / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D010290:Parents; D011292:Premedication
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam
keywords: Ease of administration; Midazolam; Parents; Premedication