Background: Successful conduct of anaesthesia in children depends on adequate premedication which comforts the anxious child. Children are vulnerable to stress response because of limited energy reserves, larger brain masses and obligatory glucose requirements. This feeling of worry and nervousness is also seen in the parents of the children undergoing
the surgery. Hence premedication becomes important in children in order to avoid anxiety in both children and parents. Methods: A prospective observational study was conducted in 78 pediatric patients aged between 2 to 10 years of age in our institution. One group received atomized intranasal midazolam 0.3mg/kg (Group M) and the other group received intranasal dexmedetomidine 1mcg/kg (Group D) 30 minutes before the surgery. Results: Mean sedation score was higher in Group M (1.58 ± 0.55) than in Group D (1.15 ± 0.36) with P value 0.002 at 5 minutes. Similarly the mean sedation score at 10 minutes for Group M was 2.34 ± 0.97 and Group D was 1.75 ± 0.71 with P-value 0.008. Separation score and mask acceptance were better with Group M compared to Group D. Conclusion: We conclude that in children, atomized intranasal midazolam produces better sedation levels, child parent separation and mask acceptance compared to intranasal dexmedetomidine.