ارزيابي نتايج حاصل از كاربرد ميدازولام داخل بيني به عنوان پيش داروي بيهوشي در كودكان پيش دبستاني

EVALUATION OF INTRANASAL MIDAZOLAM AS AN ANESTHETIC PREMEDICATION IN PRESCHOOL CHILDREN

Introduction: Preoperative psycho emotional preparation of patients is one of the principle purposes of anesthesia which can be achieved by administration of premedications. Children should receive premedication before entering the operating room due to their dependence on parents and the fear and anxiety of separation from parents. Different drugs are administered for this purpose, but considering childrenʹs sensitivity, it is wise to use the most effective and comfortable medication with least side effects. Midazolam is a rapid onset, short acting and water soluble benzodiazapine which can be administered by oral, intravenous, intramuscular, rectal or intranasal routes. The purpose of this study was to evaluate the result of intranasal midazolam administration (0.2 mg/kg ) as a premedication in children aged 2-6 years.( Min dose and enough time ) Methods: In this randomized prospective study, 100 children aged between 2-6 years old in class ASA 1 and candidates of surgery were divided into two groups; case and control. The control group received several nasal drops of normal saline, while the case group received 0.2 mg/kg nasal midazolam 20 minutes before anesthesia induction. Results: Twenty minutes after administration of the nasal drops, 14% in the control group and 68% in the case group were alert and calm. (P value=0.0) . Mask acceptance during induction of anesthesia in control and case group was 14%and 72%, respectively (P value >0.00) The recovery time in the case group was longer (P value >0.5), but no complications (nausea, vomiting, respiratory and cardiovascular problems) were seen in either group. Conclusion: Nasal midazolam with its anxiolytic, tranquilizing effects and no respiratory or cardiovascular complications is a safe drug and being better than parenteral drugs is acceptable by children.