Intranasal dexmedetomidine Vs intranasal midazolam in pediatric tonsillectomy

Abstract

Background: This randomized, double-blind study evaluated intranasal dexmedetomidine vs. midazolam as premedication in children undergoing tonsillectomy. Methods: 100 children (ASA I/II, aged 6–12 years) were randomized to receive either intranasal midazolam (0.2 mg/kg) or dexmedetomidine (1 µg/kg). Sedation, mask acceptance, hemodynamics, recovery, and postoperative outcomes were assessed. Results: Satisfactory sedation was achieved in 86% of the dexmedetomidine group and 68% of the midazolam group (p=0.03). Mask induction was satisfactory in 84% and 70%, respectively (p=0.09). Postoperative agitation scores showed no significant difference (p=0.30). No patients experienced hypotension, hypoxia, or life-threatening complications between premedication and anesthesia induction. Conclusion: Intranasal dexmedetomidine (1 µg/kg) is a safe and effective alternative to midazolam (0.2 mg/kg), offering superior sedation.