Comparing the Hemodynamic Stability, Anti-Anxiety, and Sedation Effects of Intranasal Midazolam and Ketamine as Premedication in Pediatric Hernia Repair Surgery

Fear and anxiety before entering the operating room are significant issues in pediatric anesthesia. Given that the venipuncture process is accompanied by separation anxiety, and the ease of use of intranasal premedication versus intravenous, rectal, or intramuscular methods, and considering the risk of aspiration during oral delivery in children, the purpose of this study was to compare and contrast the anti-anxiety and sedation effects of intranasal midazolam and intranasal ketamine as a premedication in pediatric hernia repair surgery.

This was a double-blind randomized clinical trial involving 36 participants aged 1 to 6 years who underwent hernia repair surgery in Bu Ali Hospital between 2020 and 2021. The child was transferred to the operating room after 30 minutes of evaluating the effects of the drug and recording the related data. In the operating room, data from an electrocardiogram device, arterial oxygen saturation level, and blood pressure were all checked. At 5 minute intervals, the patient's hemodynamics were checked and recorded. The time from the beginning to the end of anesthesia was recorded.

This study included 36 patients (18 in each group). The average age and weight of the patients were 37.71 ± 21.73 months (range = 1-72 months) and 14.60 ± 4.26 kg (range = 6.5-25 kg), respectively. Independent t-tests showed no significant difference between the two groups. Heart rate and blood pressure were measured in two groups (ketamine and Midazolam) but no significant difference was observed among the three stages (before premedication, before anesthesia, and after intubation) (P>0.05). The relationship between qualitative outcomes was analyzed using Chi-square test but no significant difference was observed.

the current study showed that there is no statistically significant difference between intranasal ketamine and midazolam in terms of effectiveness and side effects.