Nebulized vs. oral midazolam as a sedative premedication in pediatric anesthesia: A randomized controlled double-blinded study

Abstract

Objective: This study was carried out to compare different routes of midazolam administration (nebulized vs. oral) to achieve a satisfactory level of sedation, RAMSAY Sedation Score (RSS) of 4, within 30 minutes of midazolam administration in pediatric operative patients. Methods: After approval of the ethical committee in Kasr Al-ainy university hospital and obtaining written consent from parents/legal guardians; Seventy-two pediatric patients scheduled for general and urological surgical operations under general anesthesia were included in this randomized double-blinded study. Patients were randomly assigned into one of the two equal groups. Group N: 36 children received nebulized midazolam 0.2 mg/kg in 3 ml normal saline plus 5 ml clear juice 30 min before undergoing general anesthesia (GA). Group O: 36 children received oral midazolam 0.5 mg/kg in 5 ml clear juice plus nebulizer of 3 ml normal saline 30 min before undergoing general anesthesia. Results: We found no statistical difference between nebulized and oral midazolam regarding drug acceptance, peri-operative (sedation scores, hemodynamics, and side effects); P-value >0.05 for all values. Conclusion: Nebulized midazolam is a good alternative to oral midazolam as a sedative premedication in pediatrics.