Comparative study to evaluate the efficacy of intranasal dexmedetomidine versus intranasal midazolam as premedication in pediatric age group.

The intra nasal administration of midazolam has shown to be very effective,easy,a non-invasive route with better acceptance, higher safety,rapid onset of  action with higher bioavailability due to the  vascularization of nasal mucosa and bypassing hepatic metabolism.

Dexmedetomidine (DEX) is a highly selective, short- acting, alpha 2-adrenoreceptor agonist used for conscious sedation, and analgesia perioperatively.

It provides sedation, anxiolysis, and analgesic effects without causing respiratory depression.

Dexmedetomidine has been extensively investigated in the pediatric population with increasing evidence supporting its use, including as premedication.

The sedative property is  thought to be due to G-proteins activation by the presence of alpha 2a receptors in the brainstem resulting in inhibition of norepinephrine release, with a short half-life and having a bioavailability of around (72.6–92.1%) when administered via the intranasal route.

The intranasal mode of administration of dexmedetomidine has advantage over the intravenous mode in respect to ease of administration,higher bioavailability  with minimal discomfort, provide sedation without respiratory depression, reduce emergence delirium and postoperative negative behaviour such as aggression.

This study evaluates the efficacy of intranasal administered dexmedetomidine (Dose- 1.5 ug/kg ) compared to intranasal midazolam (0.1mg/kg) in pediatrics age group as per-medication.